I'm brand new to the forum and must say that the moderators and members do a great job. It surprised me to see how active the posting is for such a statistically small community.
I have to wait 2 weeks to see my doctor but was hoping to get a few perspectives on the results below:
Final Pathologic Diagnosis
Peripheral blood and bone marrow (aspirate smear, clot section and core biopsy):
- Peripheral blood with mild anemia
- Normocellular marrow with trilineal hematopoiesis and plasma cell myeloma.
- Markedly decreased iron stores.
- See comment.
Plasma cells comprise approximately a third of the marrow cellularity. chromosome analysis is pending.
Microscopic Description
Peripheral Smear
Red blood cells are decreased and show mild anisocytosis. White blood cells and platelets are adequate and morphologically unremarkable.
Aspirate Smear
The smear contains cellular spicules with degenerating cells present. The myeloid to erythroid ratio appears to be normal. Megakaryocytes are present. Plasma cells including large atypical forms are increased, comprising approximately 20% of the overall cellularity. Stainable iron is markedly decreased. Ring sideroblasts are not identified.
Aspirate Clot
The clot contains multiple marrow particles with large aggregates and sheets of atypical plasma cells, comprising approximately half of the marrow cellularity .
Core Biopsy
The biopsy consists of multiple fragments of medullary bone with a normal cellularity, approximately 50%. Aggregates and sheets of atypical plasma cells are noted similar to those seen in the aspirate clot, occupying approximately 30% of the marrow space. Background normal hematopoietic cells including megakaryocytes are present.
Flow Cytometry:
Interpretation:
Flow cytometric immunophenotyping of the submitted bone marrow aspirate is performed using antibodies to the listed analytes. Intracellular staining for immunoglobulin light chains is also performed. Electronic gates are placed around cell clusters displaying light scatter properties corresponding to lymphocytes (18% of total sample), monocytes (6% of total sample), and granulocytes (63% of total sample).
Phenotypic analysis reveals a distinct population of cells with increased light scatter properties comprising approximately 8% of the total sample which express CD38 (high density) and CD56 (high density), and exhibit kappa light chain restriction.
CD45 expression is negative.
Taken together, these results demonstrate the presence of a clonal population of cells which are immunophenotypically consistent with plasma cells, consistent with a plasma cell dyscrasia. Correlation with clinical and laboratory data suggested.
My Immunofixation showed an IgA monoclonal protein with a kappa light chain specifity. K/L ratio was 3.02.
M-Spike was 3.1 g/dl anodal and 0.4 g/dl cathodal
No bone lesions
on the full skeletal survey just osteoarthritis on the spine.
