Multiple Myeloma Differential Diagnosis

Multiple myeloma differential diagnosis - Differential diagnosis of multiple myeloma - The differential diagnosis is designed to differentiate the multiple myeloma other malignancies that affect the bone marrow, inflammatory conditions and chronic lymphoproliferative disorders.
Multiple Myeloma Differential Diagnosis

M-component <30 g / l and <10% plasma cells on bone marrow biopsy, which is not accompanied by symptoms, biomarkers or signs of multiple fibroids, or other lymphoproliferative disease called MGUS (values uncertain of monoclonal gammopathy).

The differentiation between MGUS and milovy multiple asymptomatic based on the size of the component M and the number of plasma cells in the bone marrow. However, there is no indication for treatment if and when (symptomatic) is not present in multiple myeloma.
See also: Multiple Myeloma Stages Life Expectancy
The MGUS never leads to osteolytic lesions or anemia. The low concentration of M-component in a person without symptoms should not cause concern, if the patient has no clinical symptoms. MGUS is relatively common (up to 2% in people older than 50 years and 3% of people older than 70 years). Therefore, the majority of people who have M protein in their serum have MGUS and not cancer of the bone marrow.

Other conditions that may be present M-protein are:

  • AL-amyloidosis
  • Plasmacytoma simple
  • Non-Hodgkin lymphoma of B cells (including waldenstrom macroglobulinemia)
  • Chronic lymphocytic leukemia
  • Autoimmune disease such as SLE

Multiple Myeloma Differential Diagnosis

A definite diagnosis of multiple myeloma is put in the presence of 3 characteristic aspects: proliferation of plasmacytoid cells in hematopoietic medullary tissue, the identification of lytic bone damage and the presence of homogeneous abnormal serum and/or urinary Ig. Differential diagnosis of multiple myeloma is made mainly in relation to two categories of diseases: those in which there are lytic bone lesions and those in which there has been a marked dysproteinemia. The first category includes senile osteoporosis, osteoporosis at the menopause, the illness of Recklinghausen (Recklinghausen), carcinomatosis bone metastases (prostate, thyroid).

With the disease of Recklinghausen observed hypophosphatemia, hypercalcemia, alkaline phosphatase is reduced, when carcinomatous metastases are usually observed in the foci of osteolysis surrounded by bone compaction. With all these diseases it is not observed any increase in serum Ig, no proteinuria Bence-Jones. The presence of plasma ciarnai medullary metaplasia clarifies the diagnosis of myeloma. Within dysproteinemias diseases differential diagnosis is required in relation to disease Valdenstroma in which the increase of serum IgM and microscopic examination of bone marrow shows lymphoplasmacytic proliferation, which is observed in lymphatic organs.

Difficult differential diagnosis between multiple myeloma and essential benign hypergammaglobulinemia. When the last of medullary plasmacytes below 20%, IgG — 1—2G/100 ml of serum. Differential diagnosis to be confirmed however, as a result of 2-3-year observations of the evolution of the disease; myeloma phenomena occur progressive, and serum Ig increase, while in benign hypergammaglobulinemia they remain stationary. In renal failure, with no clear etiological explanation, the doctor is obliged to investigate serum globulins and hematopoietic bone marrow, as renal symptomatology may be the only manifestation of myeloma.