3. Multiple Myeloma Flashcards
Malignant proliferation of plasma cells that infiltrate bone marrow
Multiple Myeloma
Kahler’s disease aka
Multiple Myeloma
mc primary malignant bone tumor
Multiple Myeloma
- Anemia due to diseased hematopoietic tissue by
proliferating plasma cells - Osteopenia in bones with red bone marrow
- Abnormal serum and urinary proteins
- Renal disease
Multiple Myeloma
cardinal symptom of Multiple Myeloma
Pain (aggravated by activity)
in multiple myeloma, slight strain may produce
pathologic
compression fractures that may result in
paraplegia
- Weight loss
- Cachexia
- Anemia
- Unexplained Osteoporosis
Multiple Myeloma
m/c affected bones in Multiple Myeloma
Spine and other red marrow containing bones such as flat bones
- “M spike” in 90% of patients
- IgG myeloma 50%
- Bence Jones proteinuria
Multiple Myeloma
For multiple myeloma we aspirate and biopsy bone marrow
of
sternum and ilium
reflects microscopic
appearance of nuclei in multiple myeloma
Round cell disorder
Multiple, permeative lesions, that are filled by gelatinous,
red, soft masses of neoplastic plasma cells, that are surrounded by areas of increased
osteoclastic activity
Multiple myeloma patients usually die of
pneumonia and
respiratory failure
(possibly renal failure)
May erode into adjacent bony structures and is m/c seen in nasopharynx
Extraosseous Plasmacytoma
are bones scans helpful for multiple myeloma?
NO
Bone scans will only show increased uptake in multiple myeloma if
__________ is present
pathological fracture
bone scan are negative in MM because they depend upon
osteoblastic
activity
Plasma cells release __________ , therefore osteoblasts are deficient in myeloma patients
osteoclastic activating
factor
Radiologic Hallmark of multiple myeloma
Punched Out Lesions
- Multiple round lytic lesions
- Raindrop skull
- Uniform lesions
Punched Out Lesions
may be earliest radiographic sign in Multiple Myeloma
Osteoporosis
wrinkled vertebrae
Pedicle sign is due to deficiency of
red marrow
(not a reliable sign for MM)
Osteoblastic lesions are very rare prior to
treatment with radiotherapy or drugs
over what % of patients with MM die within 3 years?
90
Agricultural workers, farmers, sheet metal workers and persons employed in the nuclear industry or
who are exposed to ________ are at increased risk
of developing ________.
wood dust, multiple myeloma
Patients with multiple myeloma commonly
present with
osteopenia and back pain
30% of MM patients present with a
pathologic fracture
Localized form of plasma cell proliferation
Solitary Plasmacytoma
Geographic radiolucent lesion, often highly
expansile, with a soap bubble appearance
Solitary Plasmacytoma
__ % of patients with a Solitary Plasmacytoma develop diffuse MM and die within 5 years
70
essential after DX of Solitary Plasmacytoma
Long term follow-up
Raindrop Skull
multiple myeloma
