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A Case of Plasma Cell Myeloma with Multilobated and Monocytoid Morphology
Plasma cell myeloma (PCM) accounts for approximately 1% of malignant tumors and 10 to 15% of hematological neoplasms. It is a malignant disease characterized by abnormal proliferation of plasma cells and monoclonal immunoglobulins or free light chains (FLCs). There are many morphological variations of the myeloma plasma cells which include mature, immature, plasmablastic, and pleomorphic types. Here, we report a rare presentation of PCM with normal serum protein electrophoresis but elevated serum FLCs and having convoluted, multilobated, and monocytoid morphology. This type of morphology is related to an aggressive clinical course and resistance to conventional chemotherapy. Moreover, absence of M protein in serum/urine electrophoresis does not rule out the diagnosis of PCM and serum FLC assays plays an important role in this kind of scenarios.
Article published online:
01 July 2022
© 2022. Spring Hope Cancer Foundation & Young Oncologist Group of Asia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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- 1 Sheik N, Variganji SK, Inugati VR. et al. Clinico-hematological profile of multiple myeloma in a teaching hospital - a 2 year study. IP Arch Cytol Histopathol Res 2019; 4 (04) 305-309
- 2 Elkins BN. Neoplasia. In: Kaplan LA, Pesce AJ. eds. Clinical Chemistry: Theory, Analysis, Correlation. 5th ed.. Missouri: Mosby Elsevier; 2010: 1051-1067
- 3 Swerdlow SH, Campo E, Harris NL. et al. WHO Classification of Tumours of Haematopoetic and Lymphoid Tissues. Revised. 4th ed.. Lyon, France: IARC Press; 2017
- 4 Drayson M, Tang LX, Drew R, Mead GP, Carr-Smith H, Bradwell AR. Serum free light-chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma. Blood 2001; 97 (09) 2900-2902
- 5 Zhang JJ, Sun WJ, Huang ZX. et al. Light chain multiple myeloma, clinic features, responses to therapy and survival in a long-term study. World J Surg Oncol 2014; 12: 234
- 6 Seili-Bekafigo I, Valković T, Babarović E, Duletić-Načinović A, Jonjić N. Myeloma cell morphology and morphometry in correlation with clinical stages and survival. Diagn Cytopathol 2013; 41 (11) 947-954
- 7 Erkut N, Çobanoğlu Ü, Sönmez M. Multiple myeloma with multilobated plasma cell nuclei. Turk J Haematol 2011; 28 (02) 158-159
- 8 Stewart AK, Fonseca R. Prognostic and therapeutic significance of myeloma genetics and gene expression profiling. J Clin Oncol 2005; 23 (26) 6339-6344