A 67-year-old man presented with acute low-back pain after moving heavy furniture. Radiography and CT scan demonstrated a collapsed vertebral body at T9 level. Serum electrophoresis demonstrated a monoclonal spike in the gamma region. Immunofixation identified a monoclonal IgG-kappa gammopathy. Quantitation of serum immunoglobulins showed IgG 3.0 g/dl, IgA 80 mg/dl, and IgM 40 mg/dl. Bence Jones protein was present in the urine. His serum calcium level was 12 mg/dl and beta-2 microglobulin level was 11 mg/l. The peripheral blood smear showed rouleaux formation, but no plasma cells were seen (Fig. 35.1). The morphologic features of bone marrow aspirate and biopsy are illustrated in Figs. 35.2 and 35.3, respectively.
KeywordsMultiple Myeloma Plasma Cell Bone Marrow Aspirate Hematologic Neoplasm Plasma Cell Leukemia
Unable to display preview. Download preview PDF.
- 1.McKenna RW, Kyle RA, Kuehl WM, et al. Plasma cell neoplasms. In Swerdlow SH, Campo E, Harris NL, et al. eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed., Lyon, Framce. IARC Press, 2008, 200–213.Google Scholar
- 2.The International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: A report of the International Myeloma Working Group. Br J Haematol 2003;121:749–757.Google Scholar