A Case of Multiple Myeloma Presenting as Non-obstructive Jaundice Due to Plasma Cell Infiltration of the Liver

ABSTRACT

Extraosseous manifestations are found in less than 5% of the patients with multiple myeloma. We reported here on a rare case of multiple myeloma presenting as non-obstructive jaundice due to diffuse plasma cell infiltration of the liver. A 70-year-old man was referred to our hospital because of general weakness, weight loss, jaundice, anemia and proteinuria. The laboratory studies showed hemoglobin 8.5g/dL, calcium 10.3mg/dL, creatinine 1.3mg/dL, AST 41IU/L, ALT 26IU/L, alkaline phosphatase 304IU/L, total bilirubin 4.0mg/dL, direct bilirubin 2.3mg/dL and 24 hour urinary protein 1,120mg. The serologic tests for hepatitis B and C virus were negative. The abdominal CT scans were normal. The urinary protein studies revealed a M component of the lamda type light chain. The bone marrow biopsy showed atypical plasma cells, and the liver biopsy showed a diffuse sinusoidal infiltration of plasma cells.