Multiple myeloma
Multiple myeloma, a plasma cell disorder, presents with osseous and extraosseous lesions affecting various organs. Common symptoms include bone pains, anemia, renal insufficiency, and susceptibility to infections. The disease can involve bones like the vertebral column, ribs, skull, and pelvis, leading to pathological fractures. Renal involvement, neuropathy, and systemic amyloidosis are also observed.
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Presentation Transcript
PLASMA CELL DYSCRASIAS Multiple myeloma osseous and extraosseous lesions
MULTIPLE MYELOMA-OSSEOUS LESIONS Multiple myeloma begins in bone marrow Bones in axial skeleton are affected most : Vertebral column, ribs, skull, pelvis, femur, clavicle & scapula Uncoupling of osteoclastic activity & bone formation Lesions in medullary cavity cancellous bone destruction of bony cortex Pathologic fractures Less commonly : Diffuse demineralization (osteopenia) erode
MULTIPLE MYELOMA-EXTRAOSSOUS LESIONS Renal involvement (Myeloma nephrosis) Precipitation of Bence Zones Proteins (Light chains) passing through glomerular filtrate combination with Tamm Horsfall proteins Tubular casts Neuropathy (Due to Hypercalcemia) Infiltration of nerve trunk roots by tumor cells polyneuropathy DCT, in
MULTIPLE MYELOMA-EXTRAOSSOUS LESIONS Systemic amyloidosis (AL) : Systemic primary generalised amyloidosis in 10% of cases involving multiple organs Liver & Spleen involvement Hepatosplenomegaly Gout : cell turn over uric acid levels Cardiovascular : Cardiomyopathy & CHF Cutaneous plasmacytomas : associated with POEMS syndrome
MULTIPLE MYELOMA-CLINICAL FEATURES Bone pains : Most common symptom - occur due to plasma cell proliferation in marrow / increased osteoclastic activity -pathological fractures may occur Anemia ( myelothisic ) Susceptibility to infections- Due to hypogammaglobulinemia Renal insufficiency Hyperviscosity syndrome- due to Hyperglobulinemia
