Ward 44

Submitted by admin on Fri, 04/15/2016 - 02:02
Description: 
ADDENDUM: This smear is again from an archival case ,its isotype lost in the mists of antiquity. It is shown at this juncture to afford a sharp contrast with the more mature myeloma in the preceding two slides. It affords an excellent example of an immature myeloma. See comment.
Comment: 
In this frame (the only one extant), chromatin is lighter, and more dispersed than that in the preceding two frames.. Nucleoli are particularily prominent and the nucleocytocytoplasmic ratio is increased. Some authorities might consider this an example of a plasmablastic myeloma. This author does not – he considers it an immature form of myeloma. An example of a true plasmablastic myeloma will be presented later in the program.
However, these morphologic observations have not been proven superior either to gene expression profiling (which can identify expression levels of cyclin D genes 1,2,and 3) or to metaphase cytogenetics (which can detect high risk translocations such as t(4;14), t(4;16) and t(4;20)) in predicting aggressiveness or shorter survival. (WHO Classification 2008 pp 206, 207). 
END OF ADDENDUM
Slide Image: 
Case Series: 
MATURE MYELOMA