Can Lymphoma and Multiple Myeloma mimic Radiologically

Abstract

Lymphoma and multiple myeloma are distinct hematologic malignancies that can present with overlapping clinical and radiological features, making diagnosis challenging. Accurate differentiation between these two diseases is critical due to their differing treatment protocols and prognosis. In this case, an 80 year old male presented with persistent abdominal pain, hypodense liver lesions, splenomegaly, and lytic bone lesions findings initially suggestive of multiple myeloma. However, further imaging revealed a heterogeneously enhancing testicular mass and retroperitoneal lymphadenopathy, which raised suspicion for lymphoma. A biopsy of the testicular mass and retroperitoneal lymph nodes confirmed the diagnosis of non-Hodgkin lymphoma, ruling out multiple myeloma. While lytic bone lesions and extramedullary involvement are characteristic of multiple myeloma, the atypical findings of testicular involvement and lymphadenopathy in this patient underscored the diagnostic complexity. This case emphasizes the necessity of integrating clinical, radiological, and pathological data to reach an accurate diagnosis. Despite imaging that suggested multiple myeloma, the histopathological confirmation of lymphoma underscores the importance of biopsy in cases with ambiguous radiological findings. Clinically, this case highlights the need for a multidisciplinary approach, as misdiagnosis could result in inappropriate treatment. Accurate and timely diagnosis is essential to guide the proper therapeutic strategy and improve patient outcomes.