Abstract
Multiple myeloma (MM) and other plasma cell proliferative disorders (PCPD) are a group of systemic diseases which share as a unifying feature the presence of clonal plasma cells. As described in previous chapters, bone marrow is the most common tissue involved, but the neoplastic plasma cells may be found in virtually any tissue/organ.
While serum protein electrophoresis and free light chain analysis are essential in early detection and follow-up, the pathologic diagnosis of MM and other PCPD is made on the bone marrow aspirate and biopsy specimen [1]. The goal of the pathologic examination of the bone marrow is to: (a) quantify bone marrow plasma cells (necessary WHO criteria for the diagnosis of MM); (b) establish PC clonality; (c) distinguish MM from lymphoplasmacytic lymphoma (LPL) and other B-cell lymphomas with plasmacytic differentiation; (d) analyze prognostic factors; (e) detect amyloid deposits; and (f) detect other potential pathologic processes, in lymphoid and myeloid compartments.
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References
McKenna RW, Kyle RA, Kuehl WM, Grogan TM, Harris NL, Coupland RW. Plasma cell neoplasms. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stain H, Thiele J, Vardiman JW, editors. WHO classification of tumours of haematopoietic and lymphoid tissue. Lyon: IARC; 2008. p. 200–13.
Morice WG, Hanson CA, Kumar S, Frederick LA, Lesnick CE, Greipp PR. Novel multi-parameter flow cytometry sensitively detects phenotypically distinct plasma cell subsets in plasma cell proliferative disorders. Leukemia. 2007;21:2043–6.
Nadav L, Katz BZ, Baron S, et al. Diverse niches within multiple myeloma bone marrow aspirates affect plasma cell enumeration. Br J Haematol. 2006;133:530–2.
Kumar S, Kimlinger T, Morice W. Immunophenotyping in multiple myeloma and related plasma cell disorders. Best Pract Res Clin Haematol. 2010;23:433–51.
Morice WG, Chen D, Kurtin PJ, Hanson CA, McPhail ED. Novel immunophenotypic features of marrow lymphoplasmacytic lymphoma and correlation with Waldenstrom’s macroglobulinemia. Mod Pathol. 2009;22:807–16.
Swerdlow SH, Berger F, Pileri SA, Harris NL, Jaffe ES, Stain H. Lymphoplasmacytic lymphoma. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stain H, Thiele J, Vardiman JW, editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 194–5.
Schuster SR, Rajkumar SV, Dispenzieri A, et al. IgM multiple myeloma: disease definition, prognosis, and differentiation from Waldenstrom’s macroglobulinemia. Am J Hematol. 2010;85:853–5.
Dao LN, Hanson CA, Dispenzieri A, Morice WG, Kurtin PJ, Hoyer JD. Bone marrow histopathology in POEMS syndrome: a distinctive combination of plasma cell, lymphoid, and myeloid findings in 87 patients. Blood. 2011;117:6438–44.
Fonseca R, Bergsagel PL, Drach J, et al. International Myeloma Working Group molecular classification of multiple myeloma: spotlight review. Leukemia. 2009;23: 2210–21.
Munshi NC, Anderson KC, Bergsagel PL, et al. Consensus recommendations for risk stratification in multiple myeloma: report of the International Myeloma Workshop Consensus Panel 2. Blood. 2011; 117:4696–700.
Kumar SK, Uno H, Jacobus SJ, et al. Impact of gene expression profiling-based risk stratification in patients with myeloma receiving initial therapy with lenalidomide and dexamethasone. Blood. 2011;118: 4359–62.
Greipp PR, Lust JA, O’Fallon WM, Katzmann JA, Witzig TE, Kyle RA. Plasma cell labeling index and beta 2-microglobulin predict survival independent of thymidine kinase and C-reactive protein in multiple myeloma. Blood. 1993;81:3382–7.
Vrana JA, Gamez JD, Madden BJ, Theis JD, Bergen III HR, Dogan A. Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens. Blood. 2009;114:4957–9.
Dearden C. Large granular lymphocytic leukaemia pathogenesis and management. Br J Haematol. 2011;152:273–83.
Thomas A, Mailankody S, Korde N, Kristinsson SY, Turesson I, Landgren O. Second malignancies after multiple myeloma: from 1960s to 2010s. Blood. 2012;119:2731–7.
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© 2014 Mayo Foundation for Medical Education and Research
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Jevremovic, D., Morice, W. (2014). Pathology of Multiple Myeloma. In: Gertz, M., Rajkumar, S. (eds) Multiple Myeloma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8520-9_3
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DOI: https://doi.org/10.1007/978-1-4614-8520-9_3
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