This slide of bone marrow contains a sheet of plasma cells. If this specimen is truly representative of the bone marrow as a whole, it is diagnostic of MM and no other tests would be necessary to make the diagnosis, although protein studies should be done to identify the type of Ig and to follow the course of the disease. Myeloma most commonly affects the marrow as a diffuse infiltration. Occasionally it can occur as separate and discrete areas with normal intervening marrow. A diagnosis of MM can be made from bone marrow examination in 60%-70% of patients with this disease. However, many times the bone marrow report must include the statement that the marrow is compatible with the diagnosis of MM but is not diagnostic. The diagnosis then is made with a combination of serum and urine protein studies, and evaluation of X-ray changes in bones.
Course Section: 10. Plasma Cell Dyscrasias
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