The treatment of patients with multiple myeloma has dramatically changed over the past 10 years due to an improved understanding of plasma. Multiple myeloma (MM) is the second most common hematologic malignancy in the US. It is typically characterized by production of large Abstract · Introduction · Ig synthesis and secretion · Diagnosis, treatment, and. Nonsecretory multiple myeloma (NSMM) is the absence of a detectable monoclonal protein in serum and urine of a multiple myeloma (MM).
|Published:||22 December 2016|
|PDF File Size:||20.74 Mb|
|ePub File Size:||39.55 Mb|
Microscopic examination of the renal biopsy showed homogenous eosinophilic deposits in the glomeruli and the vessel walls which nonsecretory multiple myeloma to be amyloid depositions with Congo red staining Figure 1Panels a and b.
Immunofluorescence examination for lambda and kappa light chains nonsecretory multiple myeloma a strong and a weak staining, respectively Figure 1Panel c.
Nonsecretory multiple myeloma
Consequently, the patient was diagnosed with lambda-type AL amyloidosis. Inset shows apple green birefringence given by deposits under polarized light Congo red stain with polarized microscopy, Following the diagnosis of AL amyloidosis, a bone marrow aspiration and biopsy were performed to exclude an nonsecretory multiple myeloma plasma cell tumor or B-cell lymphoproliferative disease.
Both conventional and fluorescent in situ hybridization t[9;22], t[4;14], t[11;14], and trisomies 7 and 8 were negative cytogenetic analyses revealed a normal karyotype 46,XY. There were lytic bone lesions of cranial and pelvic bones nonsecretory multiple myeloma conventional skeletal survey.
Nonsecretory multiple myeloma search of systemic involvement of AL amyloidosis, a thorough cardiac evaluation and an electroneuromyography were performed. Drawing blood and collecting urine are far simpler than repeat bone marrow biopsies, and so longitudinal monitoring of the nonsecretory multiple myeloma of monoclonal Ig as a surrogate for direct measurements of tumor burden has evolved as critical to the assessment of treatment responses and disease progression in MM.
Consensus response criteria for determining effectiveness of MM therapy in clinical trials and off protocol are largely based on this panel. Ig synthesis and secretion by normal long-lived PCs To understand the mechanisms underpinning NSMM, it is critical to first understand nonsecretory multiple myeloma biology of Ig synthesis nonsecretory multiple myeloma secretion by PCs, which is detailed in a review by Shapiro-Shelef and Calame.
MM is non-secretory due to a complete, real absence of nonsecretory multiple myeloma Ig production whatsoever. Such rare patients would not be able to be monitored by either traditional methods or intracellular immunofluorescence, which can be used to detect monoclonal Ig in the cytoplasm of many cases of NSMM.
A Rare Case of Nonsecretory Multiple Myeloma in Lagos, Nigeria: A Case Report and Literature Review
It is hypothesized that the mechanism of non-production is the loss of sFLC secretion by MM clones, which were initially FLC secretors, although this has not been definitively proven. MM variants or nonsecretory multiple myeloma plasma cell diseases that had measurable intracellular Ig by nonsecretory multiple myeloma but no measurable extracellular component by conventional testing.
A straight pathological evidence that they are secreted such as Ig deposits found in renal biopsies can be accessed as part of the recently described entity monoclonal gammopathy of renal significance.
This would represent a challenge for detection and treatment, too. Immunology tests showed reduced immunoglobulins but no detectable monoclonal protein by serum electrophoresis.
16 - Nonsecretory multiple myeloma
Chest X-ray, a ventilation perfusion scan and lung function tests revealed no evidence of nonsecretory multiple myeloma disease. Blood tests were requested for sFLCs, the results of which were: A year-old man with pelvic pain was found to have a solitary plasmacytoma located in the right iliac crest.
The pain was radiating down the right lower nonsecretory multiple myeloma as far as the knee joint. There was no history of trauma or history suggestive of any significant medical co-morbid conditions.
Examination revealed tenderness on the right side of the lumbosacral spine and right sacroiliac joint. There was para vertebral muscle spasm with loss of lumbar lordosis.