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13 Cards in this Set

  • Front
  • Back
Plasma cell neoplasms
MGUS

Plasma cell myeloma (multiple myeloma)

Plasmacytoma

Immunoglobulin deposition disease

Osteosclerotic myeloma (POEMS)
Monoclonal gammopathy of undetermined significance - MGUS
asymptomatic, have a M-protein spike but no symptoms, no organ damage, no b-cell lymphoma

risk to progress to MM or other myeloma
Plasma cell myeloma
bone marrow lesion primarily, but can effect multiple tissue/organ sites

skeletal destruction -> pathologic fractures, anemia, hypercalcemia

secretes a clonal immunoglobulin product known as M-protein
describe the look of osteolytic lesions in MM
punched out lesions
bones involved in MM
mostly axial but can have long bone involvement

vertebrae (often see backpain first), ribs, skull, pelvis in decreasing order of freq
waldenstrom syndrome
aka lymphoplastic lymphoma

IgM secreting

no lytic bone lesions

MGUS patients can convert to waldenstrom syndrome or MM
Plasma Cell Myeloma Clinical features
acronym CRAB

hyperCalcmia

Renal failure due to bence jones protein

Anemia

Bone Lesions - pathologic fracture


*also increased bacterial infection due to decreased antibody
plasma cell leukemia
20% or greater plasma cell in th PERIPHERAL BLOOD
Asymptomatic (smoldering) myeloma
like MGUS but with higher levels of Mprotein and marrow plasmacytosis

no treatment required
MM blood smear morphology
circulating malignant plasma cells

rouleax formation

mott cell, flame cell

gaucher inclusions

russel bodies (cytoplasmic), dutcher body (nucleus)

cytoplasmic crystalline rods
plasma cell immunophenotype
normal CD19+ CD138+

neoplastic is CD19- CD138+
plasma cell myeloma cytogenetics
translocation usually involve 14q32 with:

cyclin D1 chr11
C-MAF chr16
cyclin D3 chr6
MAFB
FGFR3

cyclinD1 and cyclinD3 are good prognosis
hyperviscosity syndrome
headache
bleeding diathesis
focal/generalized CNS problems
coronary syndrome
congestive heart failure

due to MM or waldenstrom because of excess protein in the serum