Multiple myeloma is a malignant condition where monoclonal plasma cells proliferate in the bone marrow, overproducing an abnormal immunoglobulin known as M-protein. It commonly causes lytic bone lesions, renal insufficiency from proteinuria or amyloidosis, and anemia. The diagnosis involves finding over 10% plasma cells in the bone marrow, an M-spike on serum protein electrophoresis, and often Bence Jones proteins in the urine. While the exact cause is unknown, risk factors include radiation exposure and certain genetic mutations.

1. MULTIPLE MYELOMA
Prof. Dr. Mamta Lakhey
Dept. of Pathology

2. OBJECTIVES
Multiple myeloma:
a. Aetiopathogenesis
b. Clinical manifestations
c. Morphology
d. Laboratory diagnosis

3. MULTIPLE MYELOMA
• Malignant condition of the plasma cells
• Monoclonal proliferation of neoplastic plasma cells
• Is associated with multifocal lytic lesions throughout
the skeletal system (vertebral column, ribs, skull)
• Mostly affects the elderly (5th-6th decades)

4. AETIOlOGY
• Etiology is unknown
• The following factors and abnormalities have
been implicated:
1.Radiation exposure
2.Karyotypic abnormalities
-translocations: t(11;14) (q13;q32)
-deletion of 13q
3 Mutations in oncogenes: p53 and RB genes

5. PATHOGENESIS
In Multiple myeloma (MM), single cloned plasma
cells proliferate and overproduce the same Ig ( "M-
protein" or "paraprotein." )
-The M-protein is usually an IgG (60%); IgA (20%) or
Ig light chain (κ or λ)- also called Bence Jones
protein

6. Clinical features
1. Bone lesions: bone pain, pathological fractures
2. Renal insufficiency: due to
a. Bence Jones proteinuria, amyloidosis,
3. Anaemia (weakness, lethargy)
4. Recurrent infections ( deficient or abnormal
antibody and neutropenia)

7. LAB DIAGNOSIS
a.Peripheral blood smear:
i. Anaemia: normocytic, normochromic
ii. Rouleaux formation
b. Bone marrow: > 10% plasma cells in bone marrow
c. ↑ESR
d. Biochemistry: ↑ (Ca, Urea, creatinine, Uric acid)
e. Serum Electrophoresis: M-spike due to increase in
para-proteins(abnormal immunoglobulin)
f. Ig ↑ in the blood and/or light chain in urine
g. Urine Exam shows Bence Jones protein

8. Radiological Diagnosis:
•X-ray: lytic lesions (punched out defects)

9. Serum electrophoresis

10. QUESTIONS

11. THANK YOU