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Symptoms & History
Physical Findings
Stop & Think
Lab and X-Ray
Differential Diagnosis
The Disease
Treatment
Conclusions
Quiz & Evaluation
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This adds up to a neoplastic disaster, multiple myeloma.
- A neoplasm of terminally
differentiated B cells.
- Express CD38 and
- Cytoplasmic immunoglobulins
- High serum levels of
a homogeneous immunoglobulin.
- Or fragment of an immunoglobulin.
- IgG is most common, but
can be any class
- Homogenous nature of
the protein creates the spike on the electrophoresis
.
- Free light chains, known
as Bence Jones proteins are small enough to be cleared in the kidney.
- Genetic abnormality seen
in 25% of cases,
- Older patients as a rule
- Lytic lesions of bone
often lead to pathological fractures.
- Renal failure is common.
- Excess immunoglobulins
leads to primary amyloidosis.
Not
all plasma cell neoplasms are myeloma
.
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