{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:53:26Z","timestamp":1791212006841,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    We report a rare case of non-secretory multiple myeloma (NSMM) presenting with marked eosinophilia and considerable diagnostic difficulty. A 56-year-old man was admitted with recurrent low back pain of more than 10 years\u2019 duration that had rapidly worsened over the preceding 10 days, accompanied by diffuse pain and weight loss. Laboratory evaluation showed persistent eosinophilia, thrombocytopenia, elevated lactate dehydrogenase, and increased inflammatory markers. Imaging revealed multifocal osteolytic lesions involving the skull, vertebrae, ribs, and pelvis. However, serum and urine immunofixation electrophoresis were negative, qualitative urine Bence-Jones protein testing was negative, and repeated serum free light chain testing showed a normal \u03ba\/\u03bb ratio, making the diagnosis particularly challenging. Bone marrow aspirate showed marked eosinophilia, and flow cytometry identified clonal plasma cells accounting for 6.1% of nucleated cells. Bone marrow biopsy with immunohistochemistry confirmed a plasma-cell neoplasm, while myeloma fluorescence\n                    <jats:italic>in situ<\/jats:italic>\n                    hybridization (FISH) revealed 1q21 gain\/amplification together with chromosome 13-related abnormalities, including RB1 deletion and D13S319 abnormality. After exclusion of secondary and primary\/clonal eosinophilic disorders, the patient was diagnosed with NSMM with eosinophilia. This case highlights the diagnostic challenge posed by the coexistence of marked eosinophilia and NSMM, which obscured the underlying plasma-cell malignancy despite repeatedly negative monoclonal protein studies. We also reviewed the limited literature on MM-associated eosinophilia to underscore the importance of integrating bone marrow findings, imaging, and cytogenetic evaluation in atypical cases.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1833556","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:31:11Z","timestamp":1776832271000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: A case of non-secretory multiple myeloma presenting with eosinophilia: diagnostic challenges and a focused literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Jirui","family":"Zhong","sequence":"first","affiliation":[{"name":"The First Clinical Medical School of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xikun","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Clinical Medical School of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiduo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuekui","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenghui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.4084\/mjhid.2017.053","article-title":"Non-secretory myeloma: ready for a new definition","volume":"9","author":"Corso","year":"2017","journal-title":"Mediterr J Hematol Infect 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