Hematology Case 8
Hematology Case 8
Embedded Files
Presented By Dr Shehab Sharaf Dr Mohammad Moharram
Released on 1-5-2019Patient Data
Patient Data
80 year old male
Clinical Data
Clinical Data
Admitted with severe anemia for blood transfusion. Skeletal Survey shows bony lytic lesions
Related Laboratory Results
Related Laboratory Results
S. Calcium: 3.1 mmol/L (R.R.: 2.2 - 2.58)
S.Creatinine: 435 umol/L (R.R.: 55-113)
BUN: 22.4 mmol/L (R.R.: 2.5 - 6.4)
Hemoglobin: 5.5 g/dL (R.R.: 13-17)
Albumin: 28 g/L (R.R.: 35-50)
Total Protein: 92 g/L (R.R.: 65-81)
IgG: 5370 mg/dL (R.R.: 751-1560)
ESR: 140 mm/Hr (R.R.: 0-10).
Peripheral blood Smear Shows rouleaux formation
Provisional Diagnosis
Provisional Diagnosis
Plasma Cell Neoplasm
Case Picture(s) / Photo(s)
Case Picture(s) / Photo(s)
Bone Marrow Aspirate
Bone Marrow Trephine Biopsy
H & E
CD 138
CD 56
Kappa
Lambda
Comment / Findings
Comment / Findings
B.M Aspirate: Mild Hyper-cellular B.M. for age. Increased relative number of plasma cells ≈ 12.5% of heterogeneous distribution and variable morphology (variable cell size, multi-nucleated , nuclear lobulation , cytoplasmic projections, plasmablastic appearance.) Mott cells are occasionally seen.
Bone marrow biopsy: Nodular and interstitial infiltration by sheets of plasma cells represent >60% of bone marrow cellularity. Plasma cells are positive for CD138, CD56, Kappa light chain and negative for Lambda light chain.
Final Diagnosis
Final Diagnosis
Plasma Cell Myeloma (Multiple Myeloma)
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