Plasma cell disorders

Dr. hassanali vahedian ardakani

Medical oncologist hematologist2013

differential diagnosis: monoclonal gammopathy of undetermined significance

(MGUS), smoldering multiple myeloma (SMM) Multiple myeloma Waldenstrom macroglobulinemia, solitary plasmacytoma, primary amyloidosis (AL), POEMS syndrome

Lab.test: Complete blood count Serum calcium and creatinine Serum protein electrophoresis and immunofixation Urine protein electrophoresis and immunofixation Serum free light chain Quantitation of immunoglobulins bone survey

diagnostic criteria for AL amyloidosis require the presence of all of the :following four criteria

Presence of an amyloid-related systemic syndrome (eg, renal, liver, heart, gastrointestinal tract or peripheral nerve involvement)

Positive amyloid staining by Congo red in any tissue (eg, fat aspirate, bone marrow or organ biopsy)

Evidence that the amyloid is light chain-related established by direct examination of the amyloid (eg, immunohistochemical staining, direct sequencing)

Evidence of a monoclonal plasma cell proliferative disorder (eg, presence of a serum or urine M protein, abnormal free light chain ratio, or clonal plasma cells in the bone marrow)