Multiple Meyeloma Flashcards
A ‘monoclonal gammopathy’ a malignancy of antibody producing plasma cells
Multiple Myeloma
Multiple Myeloma is called a gammopathy because the ‘gamma band’ of serum proteins, after separation by electrophoresis, contains the
Immunoglobulins
Multiple myeloma: Multiple because by the time the condition is dectected, multiple foci of tumor cells are
Present
Multiple myeloma: Myeloma because tumors form in the
Bone marrow
Plasma cell tumors that begin with a single cell
Monoclonal gammopathies
All cells of a monoclonal gammopathy tumor secrete antibody of the same
Isotype
The secreted antibody in a monoclonal gammopathy is the
Paraprotein
Multiple myeloma has many clumps of
Tumor cells
Erodes bone via stimulation of osteoclasts
Multiple Myeloma
Extramedullary – less mature B cell, secretes IgM, less bone marrow involvement
Waldenstrom’s macroglobulinemia
Only the heavy chain is secreted in
Heavy-chain disease
Only the light chains are secreted in
Light-chain disease
Light chains in in urine are
Bence-Jones Proteins
In serum electrophoresis, antibodies are mostly in the
Gamma band
The gamma band is elevated in
Multiple Myeloma
Gamma globulin = partially purified
Antibodies
Elevated gamma region in electrophoresis is the “M spike” for
Myeloma
Does not show which isotype is elevated
Serum electrophoresis
Determines which isotype is elevated
Immunofixation
Separate proteins on cellulose acetate strips.
-Flood a strip with antibodies to a specific human isotype
Immunofixation
In immunofixation, if antibody binds to plasma protein on strip, we see formation of a
Precipitate
A single type of light chain and a single type of heavy chain should be elevated in
Multiple Myeloma
In Immunofixation, the antibody to whole serum that binds all serum proteins is labeled as
S
Large oval cells with relatively uncondensed nuclei
Plasma cells
In a plasma cell slide, the blue cytoplasm represents extensive
Rough ER
In multiple myeloma, we see erosion of bone and
Hypercalcemia
