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Lymphadenopathy: Signs and Symptoms of Multiple Myeloma – White Blood Cell Pathology

by Carlo Raj, MD
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    Continuing our discussion of multiple myeloma. Apart from serum protein electrophoresis, what are the feature that you’d expect to find? Well, if you take a look at the skull, you’ll find that you have punched out lesions. It’s a monoclonal gammopathy, you’d expect there to be IgG or IgA, but not IgM, and these light chains. Light chains are once again either kappa or lambda. And majority of them will be kappa. And as the picture would show you, oftentimes, actually almost on your boards, they have to give you – If they want you to choose multiple myeloma, they’ll give you lytic bone lesions and these are punched out lesions, not wide areas of complete destruction of the bone. The reason I bring that to your attention is, when we talk about Langerhans cell histiocytosis, there will be a subtype called eosinophilic granuloma, and that type is where you would also find destruction of the bone, but it’s quite chaotic. It’s not so chaotic in plasma cell multiple myeloma. What I mean by that is it’s punched out lesion, almost looks as though that the skull was shot by a bullet, going right through it. Now, I have to be careful as to how I use the word chaotic though because it is going to cause chaos in your body. So once you start having these lytic bone lesions, the bone is very, very weak. Your patient is now prone to pathologic fractures. In addition, the bone which is the major reservoir for calcium, the calcium is now being leaked into circulation at great quantity. You can expect your patient no doubt to have hypercalcemia. That calcium is going to pass through the glomerulus. You can absolutely expect your patient to have hypercalciuria, and with all this calcium that’s...

    About the Lecture

    The lecture Lymphadenopathy: Signs and Symptoms of Multiple Myeloma – White Blood Cell Pathology by Carlo Raj, MD is from the course Lymphadenopathy – White Blood Cell Pathology (WBC).


    Included Quiz Questions

    1. Lytic lesions in bone
    2. Scorbutic rosary
    3. Bone within a bone appearance
    4. Thinned cortices
    5. Empty box appearance
    1. Osteosclerotic myeloma
    2. Smoldering
    3. Indolent
    4. Non-secretory myeloma
    5. Osteosclerotic
    1. 50-70 years
    2. 20-30 years
    3. 40-50 years
    4. 35-40 years
    5. 25-35 years

    Author of lecture Lymphadenopathy: Signs and Symptoms of Multiple Myeloma – White Blood Cell Pathology

     Carlo Raj, MD

    Carlo Raj, MD


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