Muhammad Ashraf Farooq, Hamid Shafique, Abdul Rehman, Tariq Hakim.
Supraclavicular and mediastinal Amyloid lymphadenopathy with concomitant Multiple Myeloma presenting as a lump in the neck.
J Coll Physicians Surg Pak Jan ;11(7):452-4.

We report a case that presented with a hard lump in the neck (right supraclavicular region), pain in the right shoulder and anemia. On radiological investigation, well-defined calcified soft tissue masses were detected in the right supraclavicular and right superior mediastinal regions. Multiple osteolytic lesions typical of multiple myeloma were incidentally discovered in the ribs, clavicles, scapulae, humeri and skull. Diagnosis of multiple myeloma with associated nodal amyloid deposits in the right mediastinal and supraclavicular regions was made. Histopathology with Congo red staining confirmed amyloidosis. Serum electrophoresis showed a spike in the gamma globulin region and substantiated the early radiological diagnosis of multiple myeloma. The patient was referred to a tertiary care facility for further management. The detection of coexistent multiple myeloma lesions paved the way for a confident diagnosis regarding the calcified soft tissue masses despite the extremely rare nature of the case.

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