Week 30: Myeloma

Week 30: Myeloma

1. How would you describe this x-ray? What is the text book term?

This lateral image of a skull x-ray shows multiple lytic lesions, some coalescing together, forming the classical pepper pot skull.

2. How would you investigate a patient you are suspicious may have multiple myeloma?

Blood tests including renal function, full blood count, calcium, albumin, CRP, serum electrophoresis and immunoglobulins, urinary protein and Bence Jones proteins, and a skeletal survey and bone marrow aspirate and trephine.

3. What abnormal blood results would you expect?

Raised calcium, anaemia, low white cell count and thrombocytopenia, raised ESR and CRP, abnormal kidney function, increased levels of immunoglubulins (most frequently IgG).

Guidelines for diagnosis and management have been published by the British Journal of Haematological in 2005. Read these for more detail and explanation…

This image shows an H and E stain of a bone marrow sample showing the typical plasma cells that form myeloma.

This website also explains more….

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