A patient suffering pain in his whole body – what is wrong with him?

The x-ray pictures helped find the diagnosis

His relatives brought the 66-year-old to the Hospital Diospi Suyana in a wheelchair. For three months the staff at Cusco‘s large insurance hospital told him over and over again that nothing is wrong with him, but every week he felt weaker and more and more pain in his whole body.

Because of his breathlessness Dr Martina John took an x-ray of his thorax.  On it one can see the right upper arm on which many meltdowns of the bone-substance are evident.  The following x-ray of the head immediately confirmed the suspected diagnosis: “myelomatosis”.  With this B-cell non-Hodgkin’s lymphoma the plasma cells multiply uncontrollably.  Once in the bone marrow these cells lead to dissolution of the bone.  The calvarium looks as though a hunter had fired a round of bullets into the head.

After many months of uncertainty the patient learnt the correct diagnosis from Dr John.  He was given appropriate medication and was sent back to the oncological department of Cusco’s insurance hospital.

The calvarium shows punched holes.  It is here that the bone substance has been replaced by tumour cells.  It is a so-called shotgun-skull.
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