XXXX : a clinicopathologic study of 62 consecutively autopsied cases.

@entity1 @entity644 @entity417 @entity882 @entity2741 @entity2783 @entity1066 @entity4774 @entity2348 @entity1582 @entity2629 @entity364 @entity177 @entity281 @entity158 @entity5052 @entity460 @entity204
The clinical, laboratory and pathologic findings were studied in 62 consecutively autopsied @entity1 with @entity1582 between 1954 and 1975. All @entity1 were 40 years of age or older. Bone @entity158 was the initial symptom in 2/3 of @entity1 . @entity417 (81%), @entity882 (29%), @entity2629 (41%), @entity2741 (46%) and @entity5052 (52%), were common laboratory findings at diagnosis. Ninety-seven percent had a monoclonal protein in serum or urine. Extensive plasma cell replacement of marrow was invariably seen at autopsy although in 15% of @entity1 no abnormality was found on skeletal survey. Extraskeletal spread (67%) was due to direct extension to paraosseous tissue resulting from cortical destruction and to distant organ involvement mainly of splenic red pulp and hepatic sinusoids. The @entity1 were susceptible to @entity2348 , mainly gram-negative, of the lung (56%), urinary tract (35%), and blood (24%). @entity364 was less frequent and usually consisted of superficial candidal overgrowth of gastrointestinal tract @entity1066 (18%). @entity2783 (10%) was perivascular and associated with light chain @entity644 . @entity177 as a cause of @entity204 (21%) was secondary only to @entity281 (52%). Severity of histologic findings in the kidney at autopsy had little correlation to initial BUN concentration. The median survival was 11.5 months with alkylating agent therapy (responders, 29 months; non-responders, 6 months), and 6 months with @entity4774 . Initial @entity2629 (greater than 80 mg/dl) and @entity2741 (greater than 12 mg/dl) were important prognostic indicators (median survival, less than 1 month and 3 months, respectively). A good response to alkylating agent therapy, initial BUN less than 40 mg/dl and serum @entity460 less than 12 mg/dl were favorable to prognostic indicators.
