We report here a unique case of 46,XY,del(20)(ql 1.2)/46,XY in a 76 year old man with primary amyloidosis (AL) and multiple myeloma. The patient was investigated for fatigue, hepatomegaly, and nephrotic syndrome and died several weeks later. He had 2.1 g/dl circulating IgG-lambda with IgG-lambda and free lambda light chains in the urine. The bone marrow was extensively replaced by vacuolated plasma (Mott) cells and also had dysplastic, megaloblastoid features. Amyloid and amyloid-like material were identified in both bone marrow and recto-sigmoid biopsies. The 20q deletion has been associated with myelodysplastic syndromes and acute myelogenous leukemia, however, this cytogenetic abnormality has not been reported with either amyloidosis or multiple myeloma. Recently, however, 2 myeloma patients were identifed with a t(9;20)(p24;qll.2) (Cancer Genet Cytogenet 1996;90:106-8), suggesting that aberrations of the q 11.2 region of chromosome 20 might be associated with myeloma. Also, a case of myeloma and myelodysplasia originating in a common clone has been reported (Cancer Genet Cytogenet 1998; 100:31 -5), however, although our patient had evidence of myelodysplasia the cytogenetic abnormalities identified here differ from those discovered in the other patient. If our patient's short clinical course is considered, this cytogenetic finding might define a subset of myeloma patients with more aggressive disease. Cytogenetic and morphologic studies are presented and the literature is reviewed regarding the relationship of cytogenetic findings to prognosis.
|Original language||English (US)|
|Issue number||11 PART II|
|Publication status||Published - Dec 1 2000|
ASJC Scopus subject areas
- Cell Biology