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- Neoplastic proliferation of plasma cells that produce immunoglobulins igG, IgA and IgM; resulting in end organ damage
- 1. Break down of bone ➔ hypercalcemia, fracture
- 2. Immunoglobulins clog kidney ➔ renal fail
- 3. Replacement of Marrow ➔ pancytopenia
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- Solitary, mono-ostotic = Plasmacytoma
- Polyostotic = Multiple Myeloma
- Desseminated = Diffuse skeletal Osteopenia
- Systemic = Osterosclerotic Myeloma (POEMS) - Polyneuropathy, organomegaly, endocrinopathy, myeloma protein, skin changes
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- Bloods - ESR, myeloma panel, Beta 2 microblobulin (tumor marker with prognosis)
- Urine - Bence Jones Proteins
- Skeletal Survey XR - pepper pot skull
- Bone scan - classically negative
- Classic histology: "Clock face arrangement of Chromatin", CD38 staining positive
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- Major and minor criterias
- Major - tissue biopsy, bone marrow > 30% plasma cells, monoclonal globulin spike
- Minor criteria - lytic bone lesions, 10-30% plasma cells in bone marrow
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- Chemotherapy/ stem cell transplant
- Surgical stabilization of fracture
- Kyphoplasty