In this topic, we’ll take a
look at plasma cell neoplasms.
And before we begin by looking at
topics such as multiple myeloma,
monoclonal gammopathy of undetermined
significance and so forth,
I want to make sure that you have a quick
overview of the anatomy of immunoglobulin.
And at this juncture, I’m not going to
walk you through every component here.
That is not my job.
But it is absolutely important for me
to have you focus on the light chain.
So whenever we talk about plasma
cell dyscrasias coming up,
then we will be paying
attention to light chains.
And obviously, you’re referring
to kappa and lambda light chain.
And of the two light chains,
you should definitely know that the kappa
is increased much more so than lambda,
70% of the time.
In addition, take a look
at the heavy chain.
And whenever you have
heavy chain involvement,
it would not be plasma
With heavy chain,
these will be more of your translocation
with chromosome 14, remember?
8;14, 11;14, 14;18, right?
Burkitt lymphoma, follicular
lymphoma and your mantle cell.
So what’s plasma cell?
Well, this was B-cell once upon a time and
it differentiated into a plasma cell.
I want you to get in the habit
of doing something for me.
Plasma cell responsible for
releasing and secreting what?
How many do you have?
You just spelled out gamed
if that helps you, okay?
Of all the immunoglobulin,
which one comes out first?
For any type of acute type of reaction
or acute type of infection, IgM, right?
Of all the immunoglobulins,
which one’s the biggest?
IgM, pentamer, remember?
IgM, it’s a pentamer.
Keep those in mind.
Now, the topics that we’ll
get into and the types of
plasma cell neoplasms will include,
obviously, multiple myeloma.
I’ll have to walk you through
plasmacytoma in great detail.
MGUS is the most common
plasma cell neoplasm.
It’s called monoclonal gammopathy
of undetermined significance.
Oftentimes pronounced as such, M-GUS.
Also, before I go on,
so at this point, you’ve
understood what a plasma cell is,
and responsible for producing
all these immunoglobulins.
proteins, aren’t they?
And whenever you talk about protein
synthesis from a cell, and you must have
what major organelle that
is absolutely hyperactive?
Rough endoplasmic reticulum.
Can you picture that for me?
Can you picture plasma cell?
If not, don’t worry,
I’ll show you a picture.
And I’ll show you plasma cell that
you’ll be able to identify because,
well, you have, rows upon rows
of rough endoplasmic reticulum
And by protein synthesis, I’m
referring to immunoglobulins.
We’ll talk about our M-GUS
and we’ll round things up with plasma
cell neoplasms by looking at Waldenstrom.
You absolutely must know the other
name, lymphoplasmacytic lymphoma.
Now, just like we had a discussion
and I had you compare
Hodgkin versus non-Hodgkin,
what you’ll be doing here is compare
Waldenstrom and multiple myeloma, clear?
In that way, any questions
that you get with these two,
you’ll be able to clearly
distinguish one from the other.
And in the very end,
I’ll have you –
a few notes in which you can clearly
diagnose your patient with MGUS.