Non-Secretory Myeloma or Light Chain-Producing Multiple Myeloma: A Case Report
Bibliographic record
Abstract
Nonsecretory multiple myeloma (NSMM) is a rare variant of the classic form of MM that has a similar clinical and radiologic presentation except for the absence of the M-protein in serum and/or urine. Depending on the author, NSMM may have or not detectable monoclonal free light chain in urine/serum. We describe here a case of a 51-year-old woman who presented with back pain and multiple osteolytic bone lesions. This woman had no other symptoms and her serum basic analyses were normal. She had normal serum and urine protein electrophoresis, but a monoclonal kappa light chain band in plasmatic and urinary immunofixation was found. A CT guide biopsy from the D4 vertebra showed 9% plasmocytes in the bone marrow, 100% of them with an abnormal phenotype, all being CD38+ and CD138+, confirming the diagnosis of light chain myeloma, initially presenting as NSMM. A high index of suspicion is needed to diagnose cases like this, as the biology of NSMM is not completely understood. The potential value of more sensitive quantitative diagnostic techniques for this disease is being studied. doi:10.4021/jmc156w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.005 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.008 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".