At Professional Labs/ Palestine.

 A case of Plasma Cell Myeloma

A 67 Years old female with Clinical presentations: Fatigue, Bone pain and anaemia. The Hb was 9 g/dl with normal Leukocyte and platelets count. 

The blood film was:

➡️➡️RBC MORPHOLOGY

Moderate anisocytosis, moderate macrocytes, mild polychromasia, occasional nucleated red blood cells, and marked rouleaux.

➡️WBC MORPHOLOGY

Normal in count with mild toxic granulation.

Plasma cell was seen. Myeloma cells are present with single eccentrically placed nucleus, nucleoli may be seen in finely divided chromatin and various type of inclusions may be present.

➡️PLATELET MORPHOLOGY

Adequate in number with normal morphology.

The biochemical tests:

➡️Increased total protein and reduced Albumin

➡️increased serum IgG.

➡️ Presence of monoclonal paraprotein or M protein band by using electrophoresis.

Bone Marrow aspirate:

The bone marrow aspirate is cellular (70%) and adequate for evaluation. M:E ratio normal .Both the myeloid and erythroid series demonstrate cells that progress through the full range of maturation without significant morphologic abnormalities.  megakaryocytes are not seen.  The numbers of plasma cells are increased (60%).They are variable in size and shape .They have round ecentric nucleus,coarse chromatin pattern ,prominenet nucleoli,low N/C ratio with deeply basophilic abundunt cytoplasm contain pre nuclear holo.lymphocytes are not increased.Histocytes unremarkable.parasites/Ectopic cell not found.Above all the features are suggestive of plasma cell Myeloma.

CD138 positive️

kappa light chain restriction.

Lambda light chain is negative

many thanks,

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