Abstract
Objective: To determine whether an association exists between multiple myeloma and diffuse idiopathic skeletal hyperostosis (DISH).
Design and Patients. Radiologic studies were performed over a 26-month period in a series of 97 consecutive patients with multiple myeloma (56 male and 41 female, aged 42–91 years).
Results. Both myelomatous bone lesions and hyperostosis similar to DISH were found in these patients. The prevalence of DISH in association with multiple myeloma (21 male and 8 females patients) was higher (29.8%) than in our control group (973 patients, 449 male and 524 female) or in the general population (15–20%). The involved segments of the column were thoracic in 11 males and 7 females, cervical in 8 males and 2 females, and lumbar in 5 males and 4 females. Ossifying enthesopathy in the pelvis (“whiskering”) was observed in 7 males and 1 female.
Conclusions. The pathogenesis of hyperostosis remains unknown. It is possible that the coexistence of DISH and multiple myeloma is merely an association. For this reason, it is important for the real prevalence of DISH in the general population to be defined.
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References
Kyle RA. Multiple myeloma. Review of 869 cases. Mayo Clin Proc 1975; 50: 29.
Weinstein RS. Bone involvement in multiple myeloma. Am J Med 1992; 93: 591.
Driedger H, Pruzanski W. Plasma cell neoplasia with osteosclerotic lesions. A study of five cases and review of the literature. Arch Intern Med 1974; 139: 892.
Hall FM, Gore SM. Osteosclerotic myeloma variants. Skeletal Radiol 1988; 17: 101.
Durie BGM, Salmon SE, Mundy GR. Relation of osteoclast activating factor production to extent of bone disease in multiple myeloma. Br J Haematol 1981; 47: 21.
Merlini G, Waldenstrom J, Jayakar SD. A new improved clinical staging system for multiple myeloma based on analysis of 123 treated patients. Blood 1980: 55: 1011.
DeGramont A, Benitez O, Brissaud P, Krulik M, Hubert D, Sirinelli A. Quantification of bone lytic lesions and prognosis in myelomatosis. Scand J Haematol 1985; 34: 78.
Fauré C. Radiographie et scintigraphie osseuses: quand sontelles complementaires? Ann Radiol 1983; 26: 682.
Resnick D. Degenerative deseases of the vertebral column. Radiology 1985; 156: 3.
Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement of diffuse idiopathic skeletal hyperostosis (DISH). Radiology 1978; 119: 559.
Resnick D, Shaul SR, Robins JM. Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestation. Radiology 1975; 115: 513.
Utsinger PD. Diffuse idiopathic skeletal hyperostosis. Clin Rheum Dis 1985; 11: 325.
Scutellari PN, Orzincolo C, Franceschini F. Diagnostic criteria of diffuse idiopathic skeletal hyperostosis. Eur J Intern Med 1993; 4: 215.
Alexanian R. Diagnosis and management of multiple myeloma. In: Wiernik PH, Canellos GP, Kyle RA, Schiffer CA, eds. Neoplastic diseases of the blood, vol 1. New York: Churchill Livingstone. 1985: 529.
Birgens HS, Hansen OP, Clausen NT. A methodological evaluation of 14 controlled clinical trials in myelomatosis. Scand J Haematol 1985; 35: 26.
Cozzolino F, Torcia M, Aldinucci D, Rubartelli A, Miliani A, Show AR. Production of interleukin-1 by bone marrow myeloma cells: its role in the pathogenesis of lytic bone lesions. Blood 1989; 74: 380.
Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis 1950; 9: 321.
Arlet J, Mazieres B. Hyperostose vertébrale ankylosante de Forestier et Rotes-Querol ou maladie hyperostosique. Radiol J CEPUR 1989; 9: 85.
Julkunen H, Heinonen OP, Pyorala K. Hyperostosis of the spine in an adult population. Ann Rheum Dis 1971; 30: 605.
Dwosh IL. Diffuse idiopathic skeletal hyperostosis: degenerative disease or metabolic disturbance? J Rheumatol 1983; 10: 101.
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Scutellari, P.N., Orzincolo, C. & Castaldi, G. Association between diffuse idiopathic skeletal hyperostosis and multiple myeloma. Skeletal Radiol. 24, 489–492 (1995). https://doi.org/10.1007/BF00202142
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DOI: https://doi.org/10.1007/BF00202142