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Pathology > Plasma Cell Disorders > Flashcards

Plasma Cell Disorders Flashcards

1
Q

Multiple myeloma arises from

A

Post germinal cells

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2
Q

Multiple myeloma is type of

A

Plasma cancer

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3
Q

Mutations in plasma cell in case of Multiple myeloma

A

Chr. 13q deletion (MC)
t(11;14) - Cyclin D1 overexpression
Increased Myc
Chr 17p deletion

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4
Q

Formation of abnormal antibodies is seen in which plasma cancer

A

Multiple myeloma

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5
Q

Increased no. Of plasma cells can

A

1) Replace normal BM cells (decreased RBC,WBC And platelets)
2) can lead to Cytokines secretion

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6
Q

Cytokines secreted by plasma cells

A

IL-6, TNF-alpha, MIP, DKK-4

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7
Q

Cytokines secreted by plasma cells

A

IL-6, TNF-alpha, MIP, DKK-4

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8
Q

Cytokines secretion from plasma cells can lead to

A

Increased activity of Osteoclast whereas osteoblasts normal - Results in Bone destruction - Lytic lesions

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9
Q

Most commonly affected bones in multiple myeloma

A

Vertebral bones > Ribs > Sternum > Pelvis > skull

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10
Q

Most commonly affected bones in multiple myeloma

A

Vertebral bones > Ribs > Sternum > Pelvis > skull

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11
Q

Serum calcium levels in Multiple myeloma

A

Increased - Hypercalcemia

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12
Q

Serum alkaline phosphatase levels in Multiple myeloma

A

Normal - bcz it depends on osteoblasts activity

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13
Q

Hypercalcemia in Multiple myeloma can leads to

A

Polyuria
Renal failure

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14
Q

2nd most common cause of death in multiple myeloma

A

Renal failure

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15
Q

Clinical features in multiple myeloma

A

Bony pain

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16
Q

Common antibody affected in multiple myeloma

A

IgG

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17
Q

Abnormal M proteins can stick to

A

RBCs - leads to aggregation of RBC - ROULEAU FORMATION

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18
Q

Increased viscosity of blood in Multiple myeloma can lead to involvement of

A

Brain - Confusion, dizziness

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19
Q

Increased viscosity of blood in Multiple myeloma can lead to involvement of

A

Brain - Confusion, dizziness

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20
Q

Due to presence of light chains in urine we can see

A

Bence jones Proteins

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21
Q

Most common cause of death in multiple myeloma

A

Severe infection

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22
Q

IMWG updated criteria for multiple myeloma

A

Clonal BM plasma cells >10% / Biopsy proven Bony extra medullary plasmacytoma
AND
Any 1 of myeloma defining event(MDE)

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23
Q

Myeloma defining events includes

A

Related organ/ Tissue involvement (ROTI)
Biomarkers of malignancy

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24
Q

Related organ/ tissue impairment includes

A

Ca2+ levels high - >11mg/dl
Renal dysfunction - s. Creatinine >2mg/dl
Anemia - Hb <10g/dl
Bony lesions - >1 osteolytic lesions

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25
Q

Biomarkers of malignancy includes

A

BM clonal plasma cells >60%
Light chain - Ratio of involved LC is to Uninvolved LC >100
On MRI - >1lesion (>5mm in size)

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26
Q

Morphological finding in BM Biopsy in MM

A

MOTT cell
Flame cell (Orangish red color)
Russell Body
Dutcher body

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27
Q

Flow cytometry results in Multiple myeloma

A

CD19, CD38, CD45, CD138

28
Q

In Multiple myeloma there is higher expression of which gene

A

Cyclin D1

29
Q

Blood examination results in Multiple myeloma

A

Anemia, Neutropenia, Thrombocytopenia
Increased ESR
Hypercalcemia
Normal serum alkaline phosphatase
Increased levels of Serum beta2 microglobulin and Serum IL-6 levels

30
Q

Spike seen on Serum protein Electrophoresis

A

‘M’ Spike

31
Q

Result of urine examination in multiple myeloma

A

Presence of Bence Jones proteins

32
Q

At room temperature urine in presence of Bence Jones proteins

A

Urine will be clear

33
Q

At room temperature urine in presence of Bence Jones proteins

A

Urine will be clear

34
Q

After heating urine at 40-60°C Urine will be

A

Turbid urine - because Bence Jones proteins becomes insoluble and coagulates

35
Q

Urine on heating more than >60°C

A

Urine again becomes clear

36
Q

Radiological examination in multiple myeloma

A

PET Scan
X ray

37
Q

“Punched out” lesions on skull is seen in

A

Multiple myeloma

38
Q

Treatment of Multiple myeloma

A

Dexamethasone + Lenalidomide + Bortezomib

39
Q

Diagnostic criteria for Plasma cell Leukemia

A

Peripheral blood - >20% no. Of plasma cells
Absolute count of plasma cells >2000/microlitre

40
Q

Good prognosis of multiple myeloma in case of

A

t(11;14)

41
Q

Bad prognosis indicators in multiple myeloma

A

Chr. 17p deletion
Myc overexpression
CRAB +ve
Serum beta2 microglobulin levels high

42
Q

Best bad prognosis indicator of Multiple myeloma

A

Serum beta2 microglobulin elevated levels

43
Q

Differential diagnosis of Multiple myeloma with Monoclonal gammopathy of unknown significance

A

> 50yr(1%), >70yr(5%)
Clonal plasma cells <10%
No myeloma defining events

44
Q

Differential diagnosis of multiple myeloma with. Smoldering myeloma

A

Asymptomatic myeloma
BM plasma cells 10-59%
No myeloid defining events/ No amyloid deposition

45
Q

Biopsy proven single lesion plasma tumor

A

Solitary plasmacytoma

46
Q

Solitary plasmacytoma involves which organs

A

Bones - same as MM
Soft tissues - Lungs/ paranasal sinuses/oropharynx

47
Q

Solitary plasmacytoma involves which organs

A

Bones - same as MM
Soft tissues - Lungs/ paranasal sinuses/oropharynx

48
Q

Bone marrow in Solitary plasmacytoma

A

Normal (No tumor cell)

49
Q

Skeletal screening in Solitary plasmacytoma

A

Normal ( only 1 lesion)

50
Q

Solitary plasmacytoma can progress to

A

Multiple myeloma in 10-20 years

51
Q

Treatment of Solitary plasmacytoma

A

Radiotherapy
Surgical resection

52
Q

Lymphoplasmacytic Lymphoma means

A

Excessive proliferation of Lymphocytes/plasma cells or increased mast cells

53
Q

Mutations seen in lymphoplasmacytic Lymphoma

A

MYD88 gene

54
Q

Which antibody involved in Lymphoplasmacytic Lymphoma

A

IgM antibody - Macroglobulinemia - Waldenstroms

55
Q

Lymphoid tissue involved in Lymphoplasmacytic Lymphoma

A

Lymph node, spleen, liver

56
Q

Treatment of Lymphoplasmacytic Lymphoma

A

Plasmapheresis - abnormal antibodies are removed
Rituximab - against CD20

57
Q

Abundant chain in heavy chain disease

A

Heavy chains

58
Q

Disease due to excessive alpha heavy chains

A

Seligmann disease

59
Q

Most common heavy Chain disease

A

Seligmann disease

60
Q

Seligmann disease affects which organs

A

GIT
Respiratory tract

61
Q

Clinical features of Seligmann disease

A

Malabsorption syndrome
Weight loss
Diarrhea

62
Q

Excessive mu heavy chains is associated with

A

CLL

63
Q

Light chains may appear in which heavy chain disease

A

Mu-HCD - Bence Jones proteins++

64
Q

Light chains may appear in which heavy chain disease

A

Mu-HCD - Bence Jones proteins++

65
Q

Disease caused by excessive gamma heavy chains

A

Franklin’s disease

66
Q

Clinical features in Franklins disease

A

Fever
Lymphadenopathy
Hepato and splenomegaly

67
Q

Franklin’s disease is associated with which disease

A

Rheumatoid arthritis

Pathology (14 decks)

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