Background: Multiple myeloma (MM) is characterized by clonal expansion of plasma cell in the bone marrow and production of monoclonal immunoglobulin, with bone destruction, renal failure and suppression of the normal hematopoiesis. Identification of clinical factors and laboratory diagnosis is important to characterize the stage of the disease and estimate survival.

Objective: To identify clinical and laboratory diagnosis of patients with multiple myeloma treated at HEMOPE - Foundation of Hematology and Hematology of Pernambuco.

Methods: This was an observational, transversal study with secondary data obtained from medical records. A descriptive analysis of clinical and laboratory features and prognostic factors of 112 patients diagnosed with multiple myeloma was conducted from January 2010 to December 2014.

Results: The median age was 65 years, of these 49.1% were male and 50.9% female. The most common clinical manifestations were: bone pain (70.5%), weight loss (25%) and weakness (23.2%). Anemia has been observed at diagnosis in 75% of patients and hypercalcemia in 15.2%. Regarding the staging system at diagnosis, 94 (83.9%) patients were classified as stage III Durie-Salmon and 32 (28.6%) patients in stage II of the International Staging System (ISS).

Conclusion: Our found in this study were similar to previous reported in the literature. A good characterization of the patient’s diagnosis and the use of accurate diagnostic methods are the ideal approach for better risk classification, therapeutic choice and follow-up of patients with MM.

Cauda Equina Syndrome (CES) is a rare complication of Multiple Myeloma (MM) that is a clonal plasma cell disorders. We presented a case who newly diagnosed MM which complicated with cauda equina involvement. A 51-year-old woman admitted to our hospital because of weakness and low back pain. Neurological examination demonstrated sphincter dysfunction, decreased Achilles tendon reflexes, frust hemiparesia, reflected CES. Laboratory analysis was revealed anemia, hipergammaglobulinemia and monoclonal peak in the protein electrophoresis. Magnetic resonance imaging (MRI) of the spine showed multiple vertebral compression fractures and marked contrast enhancement of the cauda equina region. The patient was diagnosed MM with bone marrow biopsy. After VAD treatment, MRI showed disappearance of infiltration. Although, there are some case reports with cauda equina involvement in myeloma patient, we could not find any case presenting with CES in newly diagnosed MM. This rare complication should be remembered in myeloma patients who presented symptoms of CES.

Autologous Stem Cell Transplantation (ASCT) is the preferred treatment for the management of multiple myeloma after initial 4-6 months of induction treatment.

Diffuse large B-cell lymphoma is a rare aggressive systemic non-Hodgkin’s B lymphoma. Subcutaneous nodules as the presenting symptom of diffuse large B-cell lymphoma is rare. We describe an unusual clinical case of large B-cell lymphoma, revealed by annular erythematous violaceous plaques.