Lytic Bone Lesions from Multiple Myeloma

Articles On Pain & Multiple Myeloma

If you have multiple myeloma, cancerous plasma cells divide and grow inside your bone marrow. Plasma cells are white blood cells that make antibodies. They're part of your immune system.

What are Lytic Lesions?

Also known as bone lesions or osteolytic lesions, lytic lesions are spots of bone damage that result from cancerous plasma cells building up in your bone marrow. Your bones can't break down and regrow (your doctor may call this remodel) as they should. This makes them thin and creates areas of weaker bones that are vulnerable to fractures. Almost everyone who has multiple myeloma will have bone lesions at some time.

Causes

In normal bone, the process of bone remodeling keeps your bones healthy and strong. Special cells called osteoclasts break down old bone. Osteoblasts lay down new bone in its place.

With myeloma, the cancerous plasma cells (called myeloma cells) make chemicals called osteoclast activating factors (OAFs). These OAFs tell the osteoclasts to break down bone faster than usual, so old bone is broken down faster than new bone is made.

This causes bone lesions, and they can make your bones weak and break more easily.

Multiple myeloma isn't the only form of cancer that can affect your bones. Other types that can cause bone lesions include:

• Breast cancer
• Kidney cancer
• Lung cancer
• Prostate cancer
• Thyroid cancer

Symptoms

Signs that multiple myeloma is affecting your bones include:

• Where does it hurt? You may feel pain in your
Back
• Chest
• Pelvis
HipsLegsArms
• Skull
• Belly
Jaw
• Teeth

The spine is the most common place for a fracture, but it can happen in other bones as well. Bones that make up the spine -- called vertebrae -- can become so weak they collapse. These are compression fractures.

These fractures are painful and can cause a hunched posture and a loss of height. They also can make it hard for you to move. Because your spine is shortened, you don't have as much space in your chest and abdomen. This can make it harder for you to breathe and eat.

With some compression fractures, the nerves between the vertebrae can be pressed or pinched. This sometimes causes pain, numbness, and weakness in the legs.

Nervous System Problems

Myeloma can lead to a number of problems with your nerves, including:

• Sudden, severe back pain
• Numbness or weakness, often in your legs
• Muscle weakness, often in your legs

If you feel something like this, get medical help right away.

Get medical help right away if you have any of these symptoms.

Diagnosis and Tests

Blood tests and X-rays can show a high probability of someone having multiple myeloma. But confirmation of the diagnosis requires a bone marrow biopsy to get tissue. A biopsy is the most common test used to diagnose lesions on your bones. Your doctor will remove a piece of tissue or take a sample of cells from your body and check it in a lab under a microscope for signs of cancer. These types of biopsies are most often used to help diagnose multiple myeloma:

Immunohistochemistry. This test treats cells from the biopsy with a special protein so they'll change color. This helps identify myeloma cells.Flow cytometry. This test treats the bone marrow sample with proteins that stick only to certain cells. It helps determine if the cells are abnormal, myeloma, another type of cancer, or a non-cancerous disease.Cytogenetic analysis (karyotyping). This test looks for changes to chromosomes in bone marrow cells and myeloma cells. Changes in your DNA can give doctors an idea of how aggressive your myeloma is.Fluorescence in situ hybridization (FISH). Doctors use special dyes to attach to your chromosomes and spotlight changes too small for other tests to find.

Read more on: cancer, multiple myeloma