Diffuse Small-Bowel Myelomatosis

To the Editor: Extramedullary plasmacytomas are an unusual manifestation of multiple myeloma. Gastrointestinal plasmacytomas occur as discrete masses, usually involving either the stomach or colon, and can be mistaken for lymphoma.1–3 We report myeloma manifested as diffuse small-bowel myelomatosis. A 74-year-old man presented with a one-year history of diffuse abdominal pain, diarrhea, and weight loss (16 kg [35 lb]). He did not have bone pain. Physical examination revealed no abnormalities except for cachexia; mild, diffuse abdominal distention without tenderness or a palpable mass; and stools that were positive for occult blood on guaiac testing. His blood count was normal . . .