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Plasma cell neoplasms:
Neoplasms of differentiated B cells
that secrete…
Plasma cell neoplasms:
Neoplasms of differentiated B cells
that secrete monoclonal Ig (M component) or uncoupled L/H chain
M spike
(monoclonal Ig)
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IgG + IgA
Multiple Myeloma
- Older adults
- IL-6 --> plasma cell growth + Ig production
- Macrophage inflmmatory protein 1 alpha --> increase RANKL --> osteoclasts
Symptoms
Multuple, skeletal lytic tumors =
PUNCHED OUT lesions
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Labs:
- MOST COMMON: IgG spike, IgA (next)
- Bone marrow plasmacytosis
- Russel bodies (Ig cytoplasmic inclusions)
- Myeloma kidney: Bence Jones precipitates
(free light chain excreted)
- Amyloidosis AL
- Blood smear: rouleaux
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Monoclonal Gammopathy of Uncertain Significance (MGUS) = Increased M proteins (>3 gm/dL) but no other features (no lytic bone lesions/hypercalcemia/amyloid)
Smoldering Myeloma =
Intermediate between MGUS + MM
- Increased M proteins (>3 gm/dL)
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