120314 plasma Flashcards
clock face chromatin
plasma cells
plasma cells and pathology–from reactive conditions–list ex
chronic infections (H pylori, osteomyelitis, endometritis) autoimmune processes (lupus, hepatitis)
plasma cells and pathology–neoplastic conditions–list ex
multiple myeloma
monoclonal gammopathy of undetermined significance (MGUS)
plasmacytoma (extramedullary plasmacytoma, solitary plasmacytoma of bone)
amyloidosis
how to tell it’s neoplasia for plasma cell proliferation?
monoclonal antibodies in serum or urine
ancillary: light chain restriction in cell cytoplasm by flow cytometry or immunohistochemistry
immunophenotypic aberrancy (CD56 on plasma cells)
M protein
monoclonal antibodies
what would you see for urine if it’s a neoplastic process?
antibodies may be filtered when kidney is damaged
free light chains (small) may pass through glomerulus
Bence Jones protein
free light chains
SPEP/UPEP
serum/urine electrophoresis
M proteins can be seen through what
electrophoresis (SPEP or UPEP)
M proteins are pretty diagnostic for
plasma or B cell tumors
immunofixation tells you
in the case of monoclonal gammopathy: what Ig it is (IgG, IgA, IgM, etc) and what light chain it is (kappa or lambda)
or if the pt is normal and has polyclonal Ig
diagnostic criteria for multiple myeloma
clonal plasma cells
M protein
end organ damage (hypercalcemia secondary to bone resorption, renal insufficiency, anemia, anemia, bone disease)
it is important to obtain both SPEP and UPEP for multiple myeloma-true or false?
true
lytic bone lesions, bone pain
multiple myeloma
can have pathologic fractures
most common cause of death for multiple myleoma pts
infection–due to immunosuppression caused by poor production of normals Igs with M protein
