Plasma cell dyscrasias 2/20

Question 1

Types of disorders

Answer 1

Multiple myeloma

solitary myeloma(plasmacytoma)=rare,presents as single mass in bone or soft tissue

smoldering myeloma=uncommon variant,lack of symptoms with high levels of monoclonal protein in blood

Waldenstrom macroglobulinemia=high levels of IgM–>hyperviscosity, older adults most commonly in association with lymphoplasmacytic lymphoma

heavy chain disease=rare monoclonal gammopathy with synthesis and secretion of free heavy chain fragments, seen with lymphoplasmacytic lymphoma and small bowel marginal zone lymphoma in malnourished populations

Question 2

primary amyloidosis

Answer 2

results from monoclonal proliferation of plasma cells secreting light chains (usually gamma) that are deposited as amyloid

Question 3

MGUS (monoclonal gammopathy of undetermined significance)

Answer 3

pts without SnS who have small to moderately large M components in their blood

elderly more affected and can transform into multiple meyloma

Question 4

abnormal plasma cells

Answer 4

plasmablasts=vesicular nuclear chromatin and a prominent single nucleolus

Bizarre multinucleated cells

Question 5

Accummulation of Ig inside plasma cells can appear as

Answer 5

flame cell=with fiery red cytoplasm

mott cells=multiple grapelike cytoplasmic droplets

russel bodie=cells containing cytoplasmic globules

dutcher bodies=cells containing nuclear globules

All cells stain with same Ab–> monoclonal proliferation

Question 6

Increased Ig in blood can result in formation of

Answer 6

rouleaux formation and increased ESR