Plasma Cell Dyscrasias Flashcards
what are the role of B cells
antibody production and antigen presenting cells
what are immunoglobulins
antibodies produced by B cells and plasma cells
what are immunoglobulins made up of
2 heavy and 2 light chains
what does an antibody recognise
a specific antigen
the Ig variable element comes form where
V-D-J region recombination early in development
what do B cells look like when they leave the marrow
immature B cells with immunoglobulin on their surface exit bone marrow
pre B cells produce what type of im
ImM and ImD
where do B cells travel to in the periphery
follicle germinal centre of the lymph node
what happens to B cells after they’ve traveled
return to the marrow as plasma cells or circulate as memory cells
appearance of a plasma cell
eccentric ‘clock face nucleus on H and E
open chromatin-synthesing mRNA
plentiful blue cytoplasma-laden with protein
pale perinuclear area
polyclonal immunoglobulins are produced in response to what
infection
autoimmune
malignancy
liver disease
what does monoclonal immunoglobulin=
paraprotein
what does paraptorein indicate
marker of an underlying clonal B cell disorder
how are immunoglobulins detected
serum electrophoresis
what does electrophoresis detect
abnormal protein bands
what is Bence Jones Protein
immunoglobulin light chains
how are bence jones protiens detected
urine electrophoresis
free light chain production by normal plasma cells is how much a day
0.5g/day
what happens to excess light chains
they leak into the urine as BJP
what are the 2 types of light chains
kappa and lambda
what are the main causes of paraproteinaemia
MGUS=56% myeloma=18% amyloidosis 10% lymphoma=5% asymptomatic myeloma=4% chronic lymphocytic leukaemia=2% waldenstrom's macroglobulinaemia=2%
what are the 2 types of effects myeloma has
direct tumour cell effects
paraprotein mediated effects
what are the direct tumour cell effects of myeloma
bone lesions, increased calcium, bone pain, replace normal bone marrow-marrow failure
what are some paraprotein mediated effects
renal failure
immune suppression
hyperviscosity
amyloid
