MORPHOLOGICAL PATTERN OF BONE MARROW IN MULTIPLE MYELOMA- A DESCRIPTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 69
Abstract
BACKGROUND Multiple myeloma is a bone marrow based plasma cell neoplasm that often presents with multifocal and disseminated involvement. Not surprisingly bone marrow examination is a key to its diagnosis along with laboratory and clinical data. Morphology of plasma cells assumes significance along with plasma cell quantity in distinguishing multiple myeloma from reactive plasmacytosis. At times the heterogeneity in plasma cell morphology leads to misdiagnosis as other neoplasms like lymphomas. The present study is an attempt to evaluate the various morphological patterns seen in bone marrow of cases diagnosed as multiple myeloma. MATERIALS AND METHODS Bone marrow of 100 consecutive cases reported as multiple myeloma in the Department of Pathology, Government Medical College, Trivandrum was analysed. The data collected included demographic profile of the patient, clinical presentation and relevant haematological and biochemical values. Quantitative and qualitative assessment of plasma cells in bone marrow was done. RESULTS The median age of diagnosis was 58 years with a male predominance. The dominant clinical presentation was bone pain. Peripheral smear examination showed increased rouleaux formation (100%) and normocytic normochromic anaemia (87%) with a single case of plasma cell leukaemia. Bone marrow study revealed that majority of the cases showed a plasma cell burden between 20% - 50% and were predominantly of mature plasma cell type. The morphologic variations of plasma cells noted were flame cells, multinuclearity, morula cells and Dutcher body. The most common pattern of infiltration seen on trephine biopsy was the nodular pattern. CONCLUSION A detailed examination of the bone marrow including a qualitative assessment of plasma cell morphology and the pattern of infiltration remains a key to the diagnosis and prognostication of cases of multiple myeloma.
Authors and Affiliations
Deepthi Raj M. L, Surupa Susan Kurien
Keywords
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- EP ID EP233240
- DOI 10.14260/Jemds/2017/1067
- Views 107
- Downloads 0
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