DPD2 Blood cancers

Question 1

Describe bone marrow aspiration

Answer 1

Small needle + aspirate
Extract liquid bone marrow
Can see individual cells, can perform cytology, determine CD expression (antigen)

Question 2

Describe bone marrow trephine

Answer 2

Thicker needle
Allows removal of core of bone marrow
Allows investigation of cellularity + architecture

Question 3

Describe lymph node core biopsies

Answer 3

Per-cutaneous US guided
Day case
No excision wound
Can detect non lymphoid material: TB, Metastatic cancer
Limitations: No lymphatic architecture, Limits use in lymphoma dx

Question 4

Describe lymph node excision biopsies

Answer 4

GA + surgery
Excision scar
Optimal for lymphoma dx + classification
TB + Granulomas
Metastatic cancer

Question 5

Describe the epidemiology of myeloma

Answer 5

2nd most common haematological malignancy
Median age = 67
Incidence increases with age
M > F
Black > Caucasian + Asian

Question 6

List 4 risk factors for myeloma

Answer 6

Obesity
Age
Genetics
Black

Question 7

What do plasma cells in multiple myeloma produce?

Answer 7

Serum monoclonal IgG or IgA: paraprotein or M-spike
Excess of monoclonal (kappa or lambda) serum free light chains
Bence jones protein: urine monoclonal free light chains
Immune paresis: Suppression of normal Ig’s + excess of malignant Ig

Question 8

List 6 features of myeloma

Answer 8

Monoclonal plasma cells in bone marrow
Paraprotein on protein electrophoresis
Osteolytic lesions
Anaemia
Infections
Kidney failure

Question 9

List 5 signs/ symptoms of multiple myeloma

Answer 9

Back pain 
Fatigue
Acute renal failure
Pneumonia
Paralysis (cord compression)