Aggressive Central Nervous System Relapse after Autologous Stem Cell Transplant in Multiple Myeloma: Case Reports and Literature Review

Figure 1

(a, b) Two massive extra-axial tissue lesions (right: 3.5 cm in the coronal plane; left: 1.4 cm in the coronal plane), spontaneously hyperdense and with strong contrast enhancement; posterior extension of the lesion with dura infiltration; diffuse involvement calvaria; (c–e) surgical removal of the frontoparietal bone flap with adherent soft tissue lesion and dura mater; (f–i) plasma cells with high mitotic activity and apoptotic bodies. (HE, 200x); invasion of the bone. (HE, 400x); (j, k) 1p32/1q21 and 17p13.2 (TP53) copy number changes evaluated by FISH: (j) (17p13.2, red), (k) (1p32, green and 1q21, red), (j) del17p13.2 (30%), and (k) 1q21 gain (72%).

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