Complete remission of necrobiotic xanthogranuloma after disappearance of monoclonal immunoglobulin induced by bortezomib, lenalidomid and dexamethasone

Czech version

Authors: Zdeněk Adam ¹; Luděk Pour ¹; Zdeněk Řehák ²; Klára Dvořáková ³; Renata Koukalová ²; Josef Feit ³; Petr Kameník ⁴; Marta Krejčí ¹; Martin Štork ¹; Martin Krejčí ¹; Viera Sandecká ¹; Ivanna Boichuk ¹; Zdeněk Král ¹
Authors‘ workplace: Interní hematologická a onkologická klinika LF MU a FN Brno ¹; Oddělení nukleární medicíny Masarykův onkologický ústav Brno ²; Patologicko-anatomické oddělení, Nemocnice Jihlava ³; Interní oddělení Nemocnice Jihlava ⁴
Published in: Vnitř Lék 2021; 67(6): 352-356
Category: Case reports

Overview

Necrobiotic xanthogranuloma (NXG) is a rare chronic condition, belonging to the group non-Langerhans cell histiocytoses, which is relevant due to the possibility of extracutaneous involvement and association with systemic diseases, particularly monoclonal gammopathy, MGUS and multiple myeloma. The case reported here NXG was diagnosed after 1 years of evolution in patient with asymptomatic multiple myeloma. After treatment with bortezomib, lenalidomid and dexamethasone, there was evident abrupt decrease of monoclonal immunoglobulin to not measurable level (complete remission of multiple myeloma) and in the same time was evident disappearance of cutaneous and hepatic lesions of NXG on FDG-PET/CT. The etiopathogenetic association of monoclonal immunoglobulin with NXG is documented in this case report with disappearance of NXG in the time of disappearance of monoclonal immunoglobulin.

Keywords:

Multiple myeloma – monoclonal gammopathy – necrobiotic xanthogranuloma

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