Plasma Cell Disorders/Dyscrasias - Multiple Myeloma Pathology Review

Описание: Plasma cell dyscrasias are a monoclonal proliferation of plasma cells that produce a clonal immunoglobulin protein (i.e., monoclonal gammopathies or paraproteinemias).
They are derived from malignant B lymphocytes. Common plasma cell dyscrasias include multiple myeloma and Waldenström's macroglobulinemia.
Plasma cell disorders are a group of hematological malignancies that are characterized by the unregulated proliferation of plasma cells in the bone marrow.

They include multiple myeloma, monoclonal gammopathy of unknown significance or MGUS(em-gus), and Waldenström’s macroglobulinemia.

Each of them produce a monoclonal or M-protein, which is a unique protein of a single type, like a protein “clone”.

Because plasma cells normally make immunoglobulins, it’s not surprising that the M-proteins produced are also immunoglobulins
In multiple myeloma, the most common M-protein produced is IgG, followed by IgA, and these immunoglobulins have both a heavy and light chain.

More rarely, the myeloma cells can only make the kappa or lambda light chain of the immunoglobulin, and in that situation, the resulting protein is called the Bence-Jones protein.

A high yield concept is the clinical presentation of multiple myeloma, which can be summarized with the mnemonic CRAB (like the animal), “C” is for hypercalcemia, which results from increased osteoclast activity due to the release of osteoclast activating factor from the malignant plasma cells, which resorbs the bone and releases free calcium into the circulation.

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