Hi everyone,
First of all, sorry for my bad english. My husband is suspect for multiple myeloma or metastatic diseas by RMI. He does all the blood test, protein bence jonse, tumoral markers and everything was fine. Now his doctor wants to do some blood test to see if multiple myeloma exist or not. He said that is unnecessary to do biopsy. My question is what kind of test is this. The result will come in a hour after the blood test.
Here attach is the RMI findings. My husband have 44 years old and he have pain since last year ( 1 year). He has osteoporosis as well. Thanks in advance,
There is normal alignament of the lumbosacral spine. There is five non rib bearing vertebral segments. Conus medullaris demonstrate normal signal intensity and it terminates at T 12 - L1.. There is diffusely abnormal appearance of the vertebral bodies of the lumbosacral spine. There is also abnormal bone marrow singnal intensity of the lower thoracic spine and of the sacrim. There are multiple hypointense to intermediate signal intensity lesion within the vertebral bodies on T1 and T2 sequence. The lesion are of varying size and they are identified within the vertebral bodies and the posterior elements. The lesion demonstrate a hyperintense to intermediate signal intensity on STIR sequence. Superior vertebral endplate fractures are noted at T10, T11 and T12 vertebral bodies with 30%, 40% and 30% height loss respectively. There is bulging of the posterior wall of the T11 body. It is indenting the thecal sac, however, it is not causing central canal stenosis. There is expansion of the left T11 pedicle with resulting mild to moderate left neural foraminal stenosis. There are also fractures of the superior and inferior vertebral endplates of the L2 vertebral body with 20% height loss anteriorly and 40 to 50% height loss centrally. There is a superior vertebral endplates fracture of the L4 vertebral body with 30% height loss centrally. L3-L4: there is a minimal posterior disc bulge. There is no central canal stenosis or neural foraminal stenosis. L4-L5: there is a subtle posterior disc protrusion, asymetric to the left. No central canal stenosis or neural foraminal stenosis. Impression: diffusely abnormal appearsnce of the vertebral bodies of the lower thoracic spine, lumbosacral spine and the sacrum. The most significant involvement is seen at T11 where there is significant vertebral compression fracture and bulging of the posterior wall of the vertebral body. There is no central canal stenosis. There is however, mild left neural foraminal stenosis. The findings of MRI are suggestive of multiple myeloma. The differential diagnosis would include metastatic disease. Work up with CT of the chest, abdomen and pelvis, as well as electrophoresis of the proteins would be recommended.
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Re: How can we know if there is multiple myeloma without bio
Elenac wrote:
> Hi everyone,
>
> First of all, sorry for my bad english. My husband is suspect for multiple
> myeloma or metastatic diseas by RMI. He does all the blood test, protein
> bence jonse, tumoral markers and everything was fine. Now his doctor wants
> to do some blood test to see if multiple myeloma exist or not. He said that
> is unnecessary to do biopsy. My question is what kind of test is this. The
> result will come in a hour after the blood test.
> Here attach is the RMI findings
Hi There Elenac:
I think you mean "MRI", not "RMI".
The most common blood serum tests for Multiple Myeloma are SEP (Serum Electrophoresis) are IEP (Immunofixation or Immunoelectrophoresis Test) and a complete metabolic panel.
The SEP will tell the doctor if there is any kind of monoclonal protein in the blood, which would suggest mutliple myeloma if it is there. The monoclonal protein (which is not normal to have any in your body) is sometimes called pararpotein or an M-Spike in the lab results.
The IEP will tell the doctor what kind of monoclonal protein is present, if there is any.
The metabolic panel will tell the doctor if he has anemia, high calcium, and other items and help determine the stage of multiple myeloma and any other problems, if he has multiple myeloma.
If there is monoclonal protein in the blood (suggests some stage of multiple myeloma), the doctor will likely schedule a bone marrow biopsy to see what the levels of monoclonal protein are in the bone marrow itself.
Hope this helps and that you understand this. Let us know if you don't. Good luck!
> Hi everyone,
>
> First of all, sorry for my bad english. My husband is suspect for multiple
> myeloma or metastatic diseas by RMI. He does all the blood test, protein
> bence jonse, tumoral markers and everything was fine. Now his doctor wants
> to do some blood test to see if multiple myeloma exist or not. He said that
> is unnecessary to do biopsy. My question is what kind of test is this. The
> result will come in a hour after the blood test.
> Here attach is the RMI findings
Hi There Elenac:
I think you mean "MRI", not "RMI".
The most common blood serum tests for Multiple Myeloma are SEP (Serum Electrophoresis) are IEP (Immunofixation or Immunoelectrophoresis Test) and a complete metabolic panel.
The SEP will tell the doctor if there is any kind of monoclonal protein in the blood, which would suggest mutliple myeloma if it is there. The monoclonal protein (which is not normal to have any in your body) is sometimes called pararpotein or an M-Spike in the lab results.
The IEP will tell the doctor what kind of monoclonal protein is present, if there is any.
The metabolic panel will tell the doctor if he has anemia, high calcium, and other items and help determine the stage of multiple myeloma and any other problems, if he has multiple myeloma.
If there is monoclonal protein in the blood (suggests some stage of multiple myeloma), the doctor will likely schedule a bone marrow biopsy to see what the levels of monoclonal protein are in the bone marrow itself.
Hope this helps and that you understand this. Let us know if you don't. Good luck!
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How can we know if there is multiple myeloma without bio
Hi Multibilly and thanks for your fast reponse. Yes you are right, MRI not RMI. Sorry.
So, i'm very conffused. What i can see on his blood test is: calcium, corrected calcium, phosphore, albumine. All these are fine. Then we have: proteines totales are fine. Total protein / L and total protein / 24 hr like the other, are ok.
My concern is the MRI which showd the bone lesions. I dont understand if they are lytic or not.
Thanks,
Elena
So, i'm very conffused. What i can see on his blood test is: calcium, corrected calcium, phosphore, albumine. All these are fine. Then we have: proteines totales are fine. Total protein / L and total protein / 24 hr like the other, are ok.
My concern is the MRI which showd the bone lesions. I dont understand if they are lytic or not.
Thanks,
Elena
-
Elenac
Re: How can we know if there is multiple myeloma without bio
Elenac wrote:
> Hi Multibilly and thanks for your fast reponse. Yes you are right, MRI not
> RMI. Sorry.
> So, i'm very conffused. What i can see on his blood test is: calcium,
> corrected calcium, phosphore, albumine. All these are fine. Then we have:
> proteines totales are fine. Total protein / L and total protein / 24 hr
> like the other, are ok.
> My concern is the MRI which showd the bone lesions. I dont understand if
> they are lytic or not.
>
> Thanks,
> Elena
That's great that the metabolic panel looks good. The MRI radiology report ended with "Work up with CT of the chest, abdomen and pelvis, as well as electrophoresis of the proteins would be recommended". The electrophoresis test will tell you more about potential monoclonal proteins in the blood and help rule out Multiple Myeloma and it sounds like the doctor is already running that test. It sounds like the radiologist also wants to do more PET/CT scans of the rest of the body to see if there any lesions in the rest of the body.
Not being a doctor, I won't comment on the MRI results. The recommended PET/CT scan will provide additional clues if there are lytic lesions present in the body. Depending on the situation, a doctor could also recommend actually doing a biopsy of a suspected lesion area. It is always a good idea to have two different radiologists look at the image results if there is a question of whether there are lytic lesions or not (I had three different people look at my recent xray and PET/CT results).
Others who have also been through this may choose to add to my comments.
> Hi Multibilly and thanks for your fast reponse. Yes you are right, MRI not
> RMI. Sorry.
> So, i'm very conffused. What i can see on his blood test is: calcium,
> corrected calcium, phosphore, albumine. All these are fine. Then we have:
> proteines totales are fine. Total protein / L and total protein / 24 hr
> like the other, are ok.
> My concern is the MRI which showd the bone lesions. I dont understand if
> they are lytic or not.
>
> Thanks,
> Elena
That's great that the metabolic panel looks good. The MRI radiology report ended with "Work up with CT of the chest, abdomen and pelvis, as well as electrophoresis of the proteins would be recommended". The electrophoresis test will tell you more about potential monoclonal proteins in the blood and help rule out Multiple Myeloma and it sounds like the doctor is already running that test. It sounds like the radiologist also wants to do more PET/CT scans of the rest of the body to see if there any lesions in the rest of the body.
Not being a doctor, I won't comment on the MRI results. The recommended PET/CT scan will provide additional clues if there are lytic lesions present in the body. Depending on the situation, a doctor could also recommend actually doing a biopsy of a suspected lesion area. It is always a good idea to have two different radiologists look at the image results if there is a question of whether there are lytic lesions or not (I had three different people look at my recent xray and PET/CT results).
Others who have also been through this may choose to add to my comments.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How can we know if there is multiple myeloma without bio
By the way, having recently gone through being diagnosed with early myeloma, I know how worrisome this all must be for both of you. You will both get through it and there is great hope and lots of treatment possibilities if he is diagnosed with myeloma. You are at the worst stage right now wondering just what is going on and I'm sure you are probably thinking about worst-case scenarios. Things will get better as you learn more about the results and final diagnosis and understand all of your options. Again, best of luck.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How can we know if there is multiple myeloma without bio
Can you tell more about these electrophoresis ? How this electrophoresis is called on the blood test result? I would like to add that the hematology dept wants to performed for now just another blood test instead the biopsy. The results would be available in about one hour.
It might be genetic test??? If someone did this test please advise.
Thanks,
Elena
It might be genetic test??? If someone did this test please advise.
Thanks,
Elena
-
Elenac
Re: How can we know if there is multiple myeloma without bio
Elenac wrote:
> Can you tell more about these electrophoresis ? How this electrophoresis is
> called on the blood test result? I would like to add that the hematology
> dept wants to performed for now just another blood test instead the biopsy.
> The results would be available in about one hour.
> It might be genetic test??? If someone did this test please advise.
> Thanks,
> Elena
See what I said before. The electrophoresis tests would be called something like the following:
SEP (Serum Electrophoresis or Serum Protein Electrophoresis) and IEP (Immunofixation or Immunoelectrophoresis Test)
The SEP will tell the doctor if there is any kind of monoclonal protein in the blood, which would suggest mutliple myeloma if it is there. The monoclonal protein (which is not normal to have any in your body) is sometimes called pararpotein or an M-Spike in the lab results.
The IEP will tell the doctor what kind of monoclonal protein is present, if there is any.
You likely wouldn't get a genetic test for myeloma back that quickly, if they ordered one. Genetic tests for myeloma are "prognostic", and help a doctor determine how well you might respond to certain types of treatments after they know whether you have myeloma or not.
I'm guessing you must have the tests back by now. Just be sure to ask the doctor to explain all of the lab results to you so that you understand everything. Let us know what you found out.
> Can you tell more about these electrophoresis ? How this electrophoresis is
> called on the blood test result? I would like to add that the hematology
> dept wants to performed for now just another blood test instead the biopsy.
> The results would be available in about one hour.
> It might be genetic test??? If someone did this test please advise.
> Thanks,
> Elena
See what I said before. The electrophoresis tests would be called something like the following:
SEP (Serum Electrophoresis or Serum Protein Electrophoresis) and IEP (Immunofixation or Immunoelectrophoresis Test)
The SEP will tell the doctor if there is any kind of monoclonal protein in the blood, which would suggest mutliple myeloma if it is there. The monoclonal protein (which is not normal to have any in your body) is sometimes called pararpotein or an M-Spike in the lab results.
The IEP will tell the doctor what kind of monoclonal protein is present, if there is any.
You likely wouldn't get a genetic test for myeloma back that quickly, if they ordered one. Genetic tests for myeloma are "prognostic", and help a doctor determine how well you might respond to certain types of treatments after they know whether you have myeloma or not.
I'm guessing you must have the tests back by now. Just be sure to ask the doctor to explain all of the lab results to you so that you understand everything. Let us know what you found out.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How can we know if there is multiple myeloma without bio
Ok, thank you very much. I think they will make IEP test and probably SEP test. What is the test back?
-
Elenac
Re: How can we know if there is multiple myeloma without bio
Elenac wrote:
> Ok, thank you very much. I think they will make IEP test and probably SEP
> test. What is the test back?
I don't know what you are asking. If you are asking how long it will take to get the results back, you should ask your doctor. It sounds like you really need to sit down with your doctor and have him explain what each test means, which tests he is going to do and when you can expect the results. Good luck.
> Ok, thank you very much. I think they will make IEP test and probably SEP
> test. What is the test back?
I don't know what you are asking. If you are asking how long it will take to get the results back, you should ask your doctor. It sounds like you really need to sit down with your doctor and have him explain what each test means, which tests he is going to do and when you can expect the results. Good luck.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How can we know if there is multiple myeloma without bio
Ok, you are right. I'm very confused. We are not used to doctors and blood tests.
He already did the total protein test ( M protein - serum and urine). They didn't find this protein. Also regular blood tests are normal. The doctor supposes that he has this disease just becouse MRI results. I think the next step is IEP. I'll kepp you posted. Thanks a lot.
He already did the total protein test ( M protein - serum and urine). They didn't find this protein. Also regular blood tests are normal. The doctor supposes that he has this disease just becouse MRI results. I think the next step is IEP. I'll kepp you posted. Thanks a lot.
-
Elenac
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