World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://www.wjon.org

Case Report

Volume 14, Number 5, October 2023, pages 438-442

Multiple Myeloma Rather Than Metastatic Lung Cancer: An Unexpected Cause of Spinal Cord Compression

Figures

Figure 1. (a) Computed tomography (CT) scan showing a neoplasm in the right lung (arrow). (b) Enhanced CT scan confirmed the existence of neoplasm in the right lung (arrow). Arrows indicate the location of the tumor. T1 (c and d), T2 (e and f), and fat-suppressed T2WI weighted spin echo magnetic resonance image of the thoracic spine in the sagittal planes (g, h). The tumor (arrow) showed hyperintensity on T1WI, mild hypointensity on T2WI, and hyperintensity on fat-suppressed T2WI, mimicking metastatic lung cancer.

Figure 2. Pathological images of the tumor. (a) (H&E, × 200) and (b) (H&E, × 400) show the morphology of tumor cells. Immunohistochemical findings. The tumor cells expressed CD38 (c, original magnification × 200) and kappa (d, original magnification × 200) without expression of lambda (e, original magnification × 200). H&E: hematoxylin and eosin.

Table

**Table 1.** Lab Results
Test	Patient results	Reference range
^aAbnormal result. WBC: white blood cell; RBC: red blood cell; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate.
WBC	6.37	3.5 - 9.5 × 10⁹/L
RBC	2.34^a	3.8 - 5.1 × 10¹²/L
Hemoglobin	74^a	115 - 150 g/L
Platelets	116^a	125 - 350 × 10⁹/L
Albumin	35.8^a	40 - 55 g/L
Total protein	78.6	65 - 85 g/L
CRP	11.4^a	0 - 3.48 mg/L
ESR	34^a	0 - 20 mm/h
Aspartate aminotransferase	15	< 35 U/L
Alanine aminotransferase	25.6	< 40 U/L
Total bilirubin	5.4	5 - 24 µmol/L
Creatinine	55	45 - 84 µmol/L
β2-microglobulin	3.48	1 - 3 mg/L
Carcinoembryonic antigen	1.39	0 - 5 ng/mL
Alpha fetal protein	1.56	0 - 8.78 ng/mL
Carbohydrate antigen125	14.7	0 - 35 U/mL
Ferroprotein	272.68^a	4.63 - 204 ng/mL
Cytokeratin 19 fragment	4.01*	0.1 - 3.3 ng/mL
Squamous cell carcinoma antigen	0.5	0 - 1.5 ng/mL
Carbohydrate antigen 19-9	8.88	0 - 27 U/mL
Calcium	2.10*	2.19 - 2.54 mmol/L