Plasma Cell Disorders Flashcards
MGUS
Monoclonal Gammopathy of Undetermined Significance
-No evidence of B cell lymphoproliferative disorder
Multiple Myeloma (MM)
Malignant plasma cell disorder of the bone marrow.
Almost 20,000 cases per year
Median age is 65 years
MM Symptoms
Often asymptomatic in early stage
Kidney dysfunction
Pain, fatigue, recurrent infxn
CNS dysfxn, neuropathy, CHF, dyspnea
Criteria for MM diagnosis
Biopsy-proven plasmocytoma
Bone marrow sample = 10 - 30% plasma cells
Elevated monoclonal IG levels in blood or urine
Osteopenia, lytic bone lesions
CRAB
Relates tissue impairment to MM. elevated Calcium Renal Failure Anemia Bone lesions
Bence Jones Protein
First tumor marker ever described.
Described patients as having albumosuria
Common Radiological findings in MM
Osteopenia or osteoporosis
Focal lytic bone
Pathological fractures
Vertebral body compression fractures
MRI findings in MM
DIffuse involvement of BM
Focal bone marrow lesions
Heterogenous bone marrow
Spinal cord compression
Oncologic emergency in MM (5% occurence) Manage w/: Corticosteroids Surgery Radiation
Anemia in MM
Normochromic, normocytic anemia occurs in 75% of patients at dx.
Renal changes in MM
Renal disease / failure
Increased serum creatinine
Creatinine above 2g/dLCaused by hypercalcemia, amyloidosis, contrast dye, cast neuropathy
MM Tx
Radiotherapy
Biphosphates
Conventional chemotherapy
Myeloablative therapy and stem cell transplant
Rouleaux formations
RBC’s stuck together that indicate MM
Waldenstrom’s Macroglobulinemia (WM)
High serum IgM. Enlargement of spleen, liver, lymph nodes Plasmactoid infiltration of BM Suppression of BM function Hyperviscosity syndrome
WM symptoms
Cytopenia Fever, night sweats, weight loss Lymphadenopathy, organopathy Hyperviscosity Cryoglobulinemia cold agglutinin neuropathy Amyloidosis
