Multiple myeloma
Discussion:
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Procedure: Ultrasound-guided Tru-cut biopsy of the right upper anterior chest wall mass.
Diagnosis: Plasma cell neoplasm consistent with multiple myeloma. The immunostains with the antibodies anti-CD138, CD38, CD79a, and MUM-1 are positive. CD20 and EMA are negative. - Laboratory investigations:
- Free Kappa=2650.00 mg/L (normal range=3.30-19.40)
- Free lambda=12.40 mg/L (normal range=5.71-26.30)
- Free Kappa/Free Lambda Ratio=213.71 (normal range=0.26-1.65 ratio).
3. Bone marrow biopsy. Consistent with IgG KAPPA restricted multiple myeloma. Approximately 10-15% plasma cells are CD38+, CD138+, IgG K+ on core biopsy immunohistochemical stains; and flow cytometry (0.3%).
4. Currently, patient is receiving chemotherapy (VRD protocol).
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