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Old 12-13-2009
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Cool Blood film question

A 56 year old male with an elevated monoclonal IgG spike on serum electrophoresis and light chain proteins in his urine. What is your diagnosis? What do you see in the slide that is characteristic for this disease? Let me know!!

Blood film question-mm.jpg
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Old 12-13-2009
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I think it is multiple myeloma , seen is eccentric plasma cell nucleus pushed to one side, and the Russel bodies are also seen pale pinkish.
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Old 12-13-2009
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Quote:
Originally Posted by DrLANC View Post
A 56 year old male with an elevated monoclonal IgG spike on serum electrophoresis and light chain proteins in his urine. What is your diagnosis? What do you see in the slide that is characteristic for this disease? Let me know!!
multiple myeloma what is answer
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Old 12-13-2009
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I'm thinking it's CLL because of the pic and the Light chains in his urine.
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Old 12-13-2009
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Thumbs Up Multiple Myeloma

It is Multiple Myeloma, both the monoclonal IgG spike and light chains in urine are the markers for MM, and what is characteristic in the slide are the perinuclear halos.
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Old 12-14-2009
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Quote:
Originally Posted by DrLANC View Post
A 56 year old male with an elevated monoclonal IgG spike on serum electrophoresis and light chain proteins in his urine. What is your diagnosis? What do you see in the slide that is characteristic for this disease? Let me know!!

Attachment 224
DrLANC,
I agree with you about diagnosis. but how can i differentiate this from "solitary myeloma" and "monoclonal gammopathies of uncertain origin" from the question??
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Old 12-14-2009
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Wink

In MM there is a SPIKE in monoclonal immunoglobulin most commonly IgG gamma(60%) and the Bence-Jones proteins which are the light chains in the urine, the pciture showed mulitple plasma cells with perinuclear halos. In MGUS there is an increase of monoclonal immunoglobulin but not a spike, MGUS is also considered benign. Solitary Myeloma (plasmacytoma) wouldn't have the markers mentioned in the question either.
Also the picture shown is of the bone marrow of a 56 year old, by definition Muliple Myeloma is a malignant neoplasm of plasma cells arising from the bone marrow of adults.
I hope I answered your question. The clues for the answer were in the question!!
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