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An unusual presentation of multiple myeloma
  1. Emma Louise Schembri1,
  2. Simon Mifsud1,
  3. Jonathan Gauci2,
  4. Adrian Mizzi3 and
  5. Peter Fsadni2
  1. 1 Department of Medicine, Mater Dei Hospital, Msida, Malta
  2. 2 Respiratory Division, Department of Medicine, Mater Dei Hospital, Msida, Malta
  3. 3 Department of Medical Imaging, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Simon Mifsud, mifsudsimon{at}


The authors report a case of a 58-year-old woman, ex-smoker, who was referred to the respiratory clinic with a presumed unresolving airspace shadowing in the right lung. Further evaluation of the shadowing with a CT thorax revealed rib lesions, a pancreatic lesion and multiple liver lesions, making the diagnosis of metastatic pancreatic carcinoma most likely. However, further blood investigations and imaging eventually revealed the cause for the shadowing to be multiple myeloma, since the unresolving shadowing was actually a rib lesion.

  • haematology (incl blood transfusion)
  • respiratory medicine
  • malignant and benign haematology

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  • Contributors ELS and SM were responsible for literature review and manuscript preparation. JG, AM and PF contributed towards editing and review of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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