Liver disease as primary manifestation of multiple myeloma in a young man

We report a 27-year-old man who presented with fatigue, moderate weight los s and progressive abdominal distension as primary manifestations of a light -chain multiple myeloma (MM). Liver scan showed an enlarged liver with mult iple low attenuation areas. Liver biopsy revealed sinusoidal infiltration b y small size cells identified as Kappa light chain-producing primitive plas ma cells by immunohistochemistry. The patient responded to three courses of EDAP. Subsequently he received intensive therapy with busulfan/melfalan an d a peripheral blood stem cell transplantation enriched for CD34(+) cells f rom his HLA-identical brother. No acute graft-versus-host disease was detec ted. Now, 12 months after transplant, the patient is asymptomatic. (C) 1999 Published by Elsevier Science Ltd. All rights reserved.