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Hematology

Question
8 out of 29
 

Russell body is found in



A WBC
B RBC

C Mast cells
D Plasma cells

Ans. D

Plasma cells

Pathology of MM:

Cells type

1. Plasma cell

2. Flame cell (Cell with cherry red cytoplasm)

3. Mott cell (Cells with multiple blue grape like cytoplasmic droplet)

Inclusion body:

1. Russell body (intracytoplasmic) found in plasma cell

2. Dutcher body (nuclear)

3. Inclusion of fibril crystalline Rods)

Myeloma Staging Systems

Note: There is a change in Harrison 18th ed., as compare to 17th ed., In 18th ed. only international staging system is mention. Durie-Salmon Staging System is not given.

Extra Edge:The Durie-Salmon staging system used previously has been found not to predict prognosis after treatment with high-dose therapy or the novel targeted therapies that have emerged. (Ref. Hari-18th ed., Pg.- 941)

Table - Myeloma Staging Systems (Ref. Hari- 17th ed., Pg.-705)

Durie-Salmon Staging System

Stage

Criteria

Estimated Tumor Burden, x 1012 cells/m2

I

All of the following:

1. Hemoglobin >100 g/L (>10 g/dL)

2. Serum calcium <3 mmol/L (<12 mg/dL)

3. Normal bone x-ray or solitary lesion

4. Low M-component production

a. IgG level <50 g/L (<5 g/dL)

b. IgA level <30 g/L (<3 g/dL)

c. Urine light chain <4 g/24 h

<0.6 (low)

II

Fitting neither I nor III

0.6–1.20

(intermediate)

III

One or more of the following:

1. Hemoglobin <85 g/L (<8.5 g/dL)

2. Serum calcium >3 mmol/L (>12 mg/dL)

3. Advanced lytic bone lesions

4. High M-component production

a. IgG level >70 g/L (>7 g/dL)

b. IgA level >50 g/L (>5 g/dL)

c. Urine light chains >12 g/24 h

>1.20 (high)

Level

Stage

Median Survival, Months

Sub classification based on serum creatinine levels

A < 177 μmol/L (<2 mg/dL)

IA

61

B > 177 μmol/L (>2 mg/dL)

IIA, B

55

IIIA

30

IIIB

15

International Staging System

β2M < 3.5, alb 3.5

I (28%)

62

β2M < 3.5, alb < 3.5 or β2M = 3.5–5.5

II (39%)

44

β2M > 5.5

III (33%)

29

Note: β2M, serum β2-microglobulin in mg/L; alb, serum albumin in g/dL; (#), % patients presenting at each stage.

These criteria are replaced by diagnostic criteria for multiple myeloma as below (AIIMS Nov 08)

Triad of MM

1. BM plasmacytosis >10%

2. Lytic lesion in the bones in X-ray

3. Urine or plasma M components

Translocation

a. t (11:14) Most common

b. Chromosome 13q deletion (It indicate poor prognosis)

Hematology Flashcard List

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