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Myeloma

Myeloma
Etiology • Neoplastic proliferation of malignant plasma cells • Monoclonal immunoglobulin (κ or λ light chain) production
Clinical Presentation • Occurs exclusively in adulthood (males 2:1 over females) • Bone pain and paresthesia • Mucosal involvement may occur as polypoid to lobular masses. • Purpura and woody induration of the tongue (macroglossia)or
gingiva may be the initial manifestation. • Solitary presentation invariably becomes multiple myeloma. • The extramedullary form occasionally becomes multiple

myeloma.
Radiographic Findings • Sharply defined radiolucencies, usually of many bones • Absence of marginal hyperostosis or opaque lining
Laboratory Findings • Monoclonal gammopathy by serum electrophoresis • Bence Jones proteinuria • Plasma cells in bone marrow aspirate
Microscopic Findings • Monotonous, diffuse plasma cell proliferation • Variable levels of differentiation and mitotic activity • Immunohistochemical demonstration of monoclonality (κ or λ
light chains)
Diagnosis • Biopsy • Immunohistochemical evaluation
Differential Diagnosis • Lymphoma • Primary osseous tumor • Metastatic tumor • Traumatic bone cyst
Treatment • Chemotherapy • Local radiation therapy
Prognosis • Poor