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Punched-out Skull
Arch Neurol. 2004;61:958.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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A 73-year-old woman with a history of multiple myeloma was initially seen with fever, weakness, and confusion. The patient was found to have a right lower lobe pneumonia and renal failure. Despite aggressive treatment, the patient had an acute respiratory decompensation and died. Premortem computed tomography of the head showed multiple lytic lesions throughout the entire calvarium (Figure 1, A). Gross examination of the calvarium, which was removed at autopsy, revealed extensive "punched-out" lesions. A radiographic image of the removed calvarium shows a unique view of the lucent or lytic lesions that cannot be obtained before death (Figure 1, B). Pathologic examination of the lytic lesions revealed characteristic features of plasmacytoma with numerous monomorphic plasma cells. These cells are mature and possess round nuclei with coarsely clumped chromatin, eccentric basophilic cytoplasm, and a perinuclear halo of clearer cytoplasm (Figure 1, C and D). Blood . . . [Full Text of this Article]
Santosh Kesari, MD, PhD;
Elizabeth A. Bundock, MD, PhD
Boston, Mass
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