IPLab:Lab 6:Multiple Myeloma: Difference between revisions
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This 63-year-old female presented with the complaint of left chest pain of approximately 4 months duration. Physical examination revealed that the pain was along the distribution of the left sixth intercostal nerve. Chest film showed a posterior mediastinal mass with partial collapse of T6. A lytic lesion of the right distal clavicle was noted on subsequent radiological examination. A bone scan revealed increased uptake in thoracic vertebrae. Serum alkaline phosphatase was elevated slightly (143 U/L). Serum protein electrophoresis was normal, while urine protein electrophoresis showed a monoclonal spike in the Gamma region. A bone marrow study was non-diagnostic. | This 63-year-old female presented with the complaint of left chest pain of approximately 4 months duration. Physical examination revealed that the pain was along the distribution of the left sixth intercostal nerve. Chest film showed a posterior mediastinal mass with partial collapse of T6. A lytic lesion of the right distal clavicle was noted on subsequent radiological examination. A bone scan revealed increased uptake in thoracic vertebrae. Serum alkaline phosphatase was elevated slightly (143 U/L). Serum protein electrophoresis was normal, while urine protein electrophoresis showed a monoclonal spike in the Gamma region. A bone marrow study was non-diagnostic. | ||
A thoracotomy was performed after the unsuccessful needle biopsy. At thoracotomy, a 3-cm posterior mediastinal mass was identified that extended to within 1-2 mm of the aorta and into the interspace between the ribs. | |||
A thoracotomy was performed after | |||
== Images == | == Images == | ||
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File:IPLab6MM4.jpg|This is a photograph of the vertebral column from this patient at autopsy. Notice the collapsed vertebra (1). There are multiple variably-sized white nodules (2) within the bone marrow. These are accumulations of malignant plasma cells in this case of multiple myeloma. | File:IPLab6MM4.jpg|This is a photograph of the vertebral column from this patient at autopsy. Notice the collapsed vertebra (1). There are multiple variably-sized white nodules (2) within the bone marrow. These are accumulations of malignant plasma cells in this case of multiple myeloma. | ||
</gallery> | </gallery> | ||
== Virtual Microscopy == | |||
<peir-vm>IPLab6MM</peir-vm> | |||
== Study Questions == | == Study Questions == | ||
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=== Reference === | === Reference === | ||
* [http://emedicine.medscape.com/article/204369-overview eMedicine Medical Library: Multiple Myeloma] | * [http://emedicine.medscape.com/article/204369-overview eMedicine Medical Library: Multiple Myeloma] | ||
* [www.merckmanuals.com/professional/hematology_and_oncology/plasma_cell_disorders/multiple_myeloma.html Merck Manual: Multiple Myeloma] | * [http://www.merckmanuals.com/professional/hematology_and_oncology/plasma_cell_disorders/multiple_myeloma.html Merck Manual: Multiple Myeloma] | ||
=== Journal Articles === | === Journal Articles === | ||
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=== Images === | === Images === | ||
* [ | * [{{SERVER}}/library/index.php?/tags/327-multiple_myeloma PEIR Digital Library: Multiple Myeloma Images] | ||
* [ | * [{{SERVER}}/library/index.php?/tags/65-amyloidosis PEIR Digital Library: Amyloidosis Images] | ||
* [http://library.med.utah.edu/WebPath/HEMEHTML/HEMEIDX.html#6 WebPath: Myeloma] | * [http://library.med.utah.edu/WebPath/HEMEHTML/HEMEIDX.html#6 WebPath: Myeloma] | ||
== Related IPLab Cases == | == Related IPLab Cases == | ||
* [[IPLab:Lab 6:Amyloidosis|Lab 6: Liver: Amyloidosis]] | |||
* [[IPLab:Lab 6:Senile Amyloidosis|Lab 6: Heart: Senile Amyloidosis]] | |||
{{IPLab 6}} | {{IPLab 6}} | ||
[[Category: IPLab:Lab 6]] | [[Category: IPLab:Lab 6]] | ||