INTERESTING IMAGE Detection of Extramedullary Multiple Myeloma in Liver by FDG-PET/CT

lesion in the right shoulder that was detected by contrast-enhanced computed tomography (CT) and 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET)/CT (Fig. 1). Excisional biopsy revealed infiltration of plasma cells with anaplastic features, consistent with solitary plasmacytoma (PC). Serum analysis showed elevation of serum free lambda light chain levels (27.78 mg/l), with an abnormally high kappa:lambda ratio (2.33) and high total proteins (10.4 g/dl). Serum protein electrophoresis revealed an M spike in the gamma-globulin region (56.1 %=5.8 g/dl). Subsequently, 18F-FDG PET/CT revealed another hyper-metabolic mass in the right lobe of the liver (Fig. 2). CT-guided biopsy of the liver lesion revealed plasma cell myeloma, consistent with multiple myeloma (Fig. 3). Multiple myeloma presenting as nodular liver masses i