Plasma Cell Neoplasms Flashcards
(30 cards)
Where does Solitary Extraosseous (extramedullary) Plasmacytoma most commonly arise?
- What % have detectable M protein
- What is the likelyhood of developing MM
Nasal cavity, oropharynx, or larynx
- No M protein
- Most do NOT develop MM
T/F: Plasma cell leukemia presents abruptly and follows an aggressive course; and 1/2 cases are de novo.
True
Some cases of MM are bcl-1(+)(cyclin-D1), what does this correlate with?
t(11;14) translocation
MM Prognosis factor:
-B2-microglobulin
Higher levels - Adverse
In patients with MGUS after 20 years, how many will develop overt Myeloma?
33%
What is the most common paraprotein idiotype (light chain) in MM?
kappa
Multiple Myeloma IHC:
-Positive for (5)
- CD38
- CD138
- CD56
- kappa or lambda (cytoplasmic)
- PCA1
What % of myeloma cases are Nonsecretory?
5%
What is the risk per year of progression to MM or another plasma cell neoplams in patients with MGUS?
0.5-1%
Myeloma prognosis by FISH:
-Shortest survival (24 months) (3)
- t(4;14)
- t(14;16)
- 17p13 Deletion
MM Molecular/Cytogenetics:
-Most common Rearrangement
CCND1/IgH fusion
-t(11;14)
Diagnostic criteria for Plasma cell leukemia.
> 20% plasma cells in peripheral blood
>2.0x10^9/L
MGUS is found in __% of adults over the age of 50, and __% of adults over the age of 70.
- 3% over 50
- 5% over 70
Diagnostic criteria for Asymptomatic (smoldering) Myeloma.
-M protein >3.0 g/dL
OR
->10% clonal plasma cells in BM
What % of patients with an M protein are classified as MGUS?
60%
Where does Solitary Osseous Plasmacytoma (solitary plasmacytoma of bone) most commonly arise?
- What % have detectable M protein
- What is the likelyhood of developing MM
Vertebrae, Ribs, and Pelvis
- 50% have M protein
- 75% develop MM in 10 years
Criteria for Symptomatic MM.
M protein (any amount) \+ Clonal plasma cell in BM (any %) or plasmacytoma \+ Organ impairment (CRAB)
Multiple Myeloma - Renal Manifestations:
-Mechanism of Tubular Injury
Hypercalcemia and/or Hyperuricemia induced Tubular Injury
What is the aberrant IHC finding in plasma cell leukemia?
CD56 Negative
Multiple Myeloma - Renal Manifestations:
-AL Amyloidosis association
Lambda Light Chains
Myeloma prognosis by FISH:
-Longest survival (>50 months)
- t(11:14)
- No anomalies
What does CRAB stand for in symptomatic MM.
Organ Impairment:
- Calcium (High)
- Renal insufficiency
- Anemia
- Bone lesions
Multiple Myeloma IHC:
-Negative for (6)
- CD19
- CD20
- CD21
- CD22
- CD45
- sIg
What cytogenetic abnormality has a high incidence in Plasma cell leukemia?
monosomy 13
