![]() Repeat protein electrophoresis confirmed a 2.77 g/dL M-spike consisting of IgG lambda (see table 2b). IgA and IgM were 63 mg/dL and 61 mg/dL respectively. Metastatic bone survey: NO evidence of osteolytic or osteoblastic bone lesions. Flow cytometry showed the presence of CD56 positive, CD19 negative, lambda light chain restricted plasma cells. Overall plasmacytosis was estimated at 30% after CD138 staining. Albumin was 3.6 g/dL (see table 2a).īone marrow aspirate and biopsy showed a marrow plasmacytosis of 30% against an overall background of normal to mildly increased marrow cellularity, myeloid and erythroid precursors were unremarkable. The patient's calcium was 9.5 mg/dL, creatinine 0.7 mg/dL. White cell count was 11,000 μL, with a normal differential. Hemoglobin was 13.2 g/dL, with hematocrit 39%. Staining of marrow and fat pad for amyloid Tissue biopsy to diagnose solitary osseous or extraosseous plasmacytoma Initial Diagnostic Workup for Multiple Myeloma – Useful Under Some Circumstances ![]() Unilateral bone marrow aspirate + biopsy, including bone marrow immunohistochemistry and/or bone marrow flow cytometryįluorescence in situ hybridization (FISH) ġb. Urine immunofixation electrophoresis (UIFE) Serum immunofixation electrophoresis (SIFE) Initial Diagnostic Workup for Multiple Myeloma – Required As a reminder, the diagnostic work-up required for multiple myeloma as well as tests that are useful under certain circumstances can be found in table 1.a and 1.b, respectively as listed in the NCCN Guidelines for multiple myeloma.ġa. Further work up including serum protein electrophoresis (SPEP) and immunofixation (IFE) indicated the presence of an IgG lambda monoclonal spike (M spike) of 2.52 g/dL. A CBC and chemistry panel were obtained during her evaluation and showed an elevated total protein level of 9.3 g/dL. ![]() Section Head - Hematological Malignancies and BMTĪ 57-year-old woman (NB) presented to her primary care doctor for a routine annual visit and physical. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |