Hematopathology
Arun Puri; Heena Wadhwa; Navtej Singh
Abstract
Multiple Myeloma is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells. It is characterized by a clinical pentad of 1) anemia, 2) a monoclonal protein in the serum or the urine or both, 3) bone leisons and or bone pain, 4) hypercalcemia >11.5g/dl and ...
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Multiple Myeloma is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells. It is characterized by a clinical pentad of 1) anemia, 2) a monoclonal protein in the serum or the urine or both, 3) bone leisons and or bone pain, 4) hypercalcemia >11.5g/dl and 5) renal insufficiency. Non secretory multiple myeloma is a rare variant of the classic form of multiple myeloma and accounts for 1% to 5 % of all cases of multiple myeloma. The clinical presentation and radiographic findings of non-secretory multiple myeloma and multiple myeloma are the same. The diagnosis of multiple myeloma requires the demonstration of monoclonal gammopathy in the serum or urine. In non-secretory multiple myeloma, however no such gammopathy can be demonstrated, making the diagnosis more difficult. We describe a 60 year old woman who initially presented with back pain which when further investigated by complete blood count revealed hemoglobin of 13g/dl, Total Leukocyte Count of 10,890 and platelet count of 1.5 lac/cmm. Viral markers revealed HCV positive. Hypercalcemia with a serum calcium level of 12.5g/dl was also demonstrated. MRI revealed multiple lytic bony lesions. No monoclonal gammopathy was found in the serum or urine and bone marrow biopsy showed marked plasmacytosis of > 45%. We present a case of Non Secretory multiple myeloma because of its illusive nature and rare entity.
Noushin Afshar Moghaddam; Diana Taheri; Azar Naimi; Faegheh Taghizadeh; Shahram Taheri
Volume 2, Issue 2 , April 2007, , Pages 77-79
Abstract
A 54 year old man with history of cardiomyopathy and chronic fibrillation first presented with bloody diarrhea. Then during the assessment of his abnormal lab. data revealed cast nephropathy in renal biopsy, gamma peak in protein electrophoresis and fine lytic lesions in skull graphy. His bone marrow ...
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A 54 year old man with history of cardiomyopathy and chronic fibrillation first presented with bloody diarrhea. Then during the assessment of his abnormal lab. data revealed cast nephropathy in renal biopsy, gamma peak in protein electrophoresis and fine lytic lesions in skull graphy. His bone marrow aspiration showed multiple myeloma and blood smear revealed plasma cell leukemia. Our patient was diagnosed to have multiple myeloma and plasma cell leukemia Plasma cell leukemia is a rare form of plasma cell dyscrasia.The second type evolves as a terminal event in some of the patients with multiple myeloma. PCL and multiple myeloma simultaneously recognizes in this case(very rare event).