Lymphadenopathy: Plasma Cell Neoplasms – White Blood Cell Pathology

00:00 In this topic, we’ll take a look at plasma cell neoplasms.

00:03 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.

00:18 And at this juncture, I’m not going to walk you through every component here.

00:21 That is not my job.

00:23 But it is absolutely important for me to have you focus on the light chain.

00:30 So whenever we talk about plasma cell dyscrasias coming up, then we will be paying attention to light chains.

00:36 And obviously, you’re referring to kappa and lambda light chain.

00:40 And of the two light chains, you should definitely know that the kappa is increased much more so than lambda, 70% of the time.

00:50 In addition, take a look at the heavy chain.

00:53 And whenever you have heavy chain involvement, it would not be plasma cell dyscrasia.

00:58 With heavy chain, these will be more of your translocation with chromosome 14, remember? 14.

01:05 8;14, 11;14, 14;18, right? Burkitt lymphoma, follicular lymphoma and your mantle cell.

01:16 So what’s plasma cell? What’s happening? Well, this was B-cell once upon a time and it differentiated into a plasma cell.

01:24 I want you to get in the habit of doing something for me.

01:27 Plasma cell responsible for releasing and secreting what? Immunoglobulin.

01:32 How many do you have? Five.

01:34 G-A-M-E-D.

01:37 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? Immediate, immediate.

01:51 Of all the immunoglobulins, which one’s the biggest? IgM, pentamer, remember? Pentamer.

01:58 IgM, it’s a pentamer.

01:59 Keep those in mind.

02:03 Now, the topics that we’ll get into and the types of plasma cell neoplasms will include, obviously, multiple myeloma.

02:10 I’ll have to walk you through plasmacytoma in great detail.

02:13 MGUS is the most common plasma cell neoplasm.

02:19 It’s called monoclonal gammopathy of undetermined significance.

02:24 M-G-U-S, M-GUS.

02:27 Oftentimes pronounced as such, M-GUS.

02:31 Also, before I go on, so at this point, you’ve understood what a plasma cell is, and responsible for producing all these immunoglobulins.

02:39 Immunoglobulins are 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? Good.

02:53 Rough endoplasmic reticulum.

02:55 Can you picture that for me? Can you picture plasma cell? If not, don’t worry, I’ll show you a picture.

02:59 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 responsible for protein synthesis.

03:10 And by protein synthesis, I’m referring to immunoglobulins.

03:14 We’ll talk about our M-GUS and we’ll round things up with plasma cell neoplasms by looking at Waldenstrom.

03:22 You absolutely must know the other name, lymphoplasmacytic lymphoma.

03:26 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.

03:43 And in the very end, I’ll have you – a few notes in which you can clearly diagnose your patient with MGUS.