Plasma cell neoplasm

• Plasma cell

• Ig

• M component, para protein

• Monoclonal gammopathy

Multiple Myeloma

• Bone marrow based• Median age 70• Multifocal, bone, tumor masses• Serum paraprotein, Urine Bence-Jones

protein• Osteolytic lesions, bone pain, hyper

calcemia, anemia• Renal failure

• Morphology– Increased plasma cells ( mature, immature and

anaplastic)– Mass of plasma cells– Ig inclusions

• Immuno: CD20 neg, cytoplasmic Ig IgG>IgA

Lambda

Plasmacytoma

• Localized osseous or extra osseous plasma cell tumor

kappa

Monoclonal Gammopathy of Undetermined Significance

MGUS• Asymptomatic

• M protein (less than myeloma)

• BM Plasmacytosis <10%

• 25% progress to Multiple Myeloma

Lymphoplasmacytic lymphoma

• B cell lymphoma

• Leukemic with bone marrow involvement

• Low grade

• Paraprotein IgM

• Waldensrom macroglobulinemia