Plasma cell disorders

Question 1

Multiple Myeloma

Answer 1

Malignant prolif of plasma cells in bone marrow
Primary malignancy of bone; 65-74yo
CD38+, CD138+, CD79a+, cIg-; CD19-
High serum IL-6 (growth factor for plasma cells)
Bone pain w/ hypercalcemia; activate RANK on osteoclasts, lytic lesions on xray
Elevated serum protein: M spike d/t monoclonal IgG or IgA
AL amyloidosis: Bence Jones proteins in the urine

Question 2

Plasma cell disorders

Answer 2

Plasma cell dyscrasia: Multiple Myeloma, MGUS, Waldenstrom Macroglobulinemia
Plasma cells - CD38+, CD138+; clock face

Question 3

MGUS

Answer 3

Monoclonal gammopathy of undetermined significance
M spike - isolated
No lytic lesions/hypercalcemia/AL amyloid/Bence-Jones proteinuria

Question 4

Waldenstrom Macroglobulinemia

Answer 4

Lymphoblastic lymphoma
CD19+, CD79a+, CD20+, CD38+, IgM
B cell lymphoma w/ monocomal IgM prd
MYD88 mutation --> NFkB activation
Russell bodies --> cytoplasm
Dutcher bodies --> nucleus
Hepato/splenomegaly
Hyperviscosity sxs
Tx: plasmapheresis

Question 5

Multiple myeloma

Answer 5

CD38+, CD138+, CD79a+, cIg-; CD19-

Question 6

Waldenstrom Macroglobulinemia

Answer 6

CD19+, CD79a+, CD20+, CD38+, IgM