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{{Multiple myeloma}}
{{Multiple myeloma}}
{{CMG}}
{{CMG}} {{AE}}{{HL}} {{shyam}}
 
==Overview==
==Overview==
Biopsy and genetic testing may be helpful in the diagnosis of mulriple myeloma.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref>
[[Bone marrow biopsy]] is an important [[Diagnosis|diagnostic]] test in [[multiple myeloma]]. [[Bone marrow biopsy]] consists of the collection of the [[Bone marrow biopsy|bone marrow aspirate]] and the solid core [[biopsy]]. Tests that can be performed on the [[bone marrow biopsy]] include [[karyotyping]] (chromosomal analysis) and [[immunophenotyping]].


==Bone Marrow Biopsy==
==Other Diagnostic Studies==
*Bone marrow biopsy is usually performed to estimate the percentage of bone marrow occupied by plasma cells.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref>
*Examination of abnormal plasma in the bone marrow is the only way to confirm a diagnosis.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref>
*The percentage of plasma cells is also used in the diagnostic criteria of multiple myeloma.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref>
 
==Cytogenetic tests==
*Detects any chromosomal mutations occurring in multiple myeloma such as chromosome 13 deletion or chromosome 14 translocation.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>
 
;Karyotyping<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>
:A sample of blood or liquid bone marrow (from a bone marrow aspiration) is examined under the microscope to look for changes in the chromosomes. Karyotyping can find large chromosomal changes like a missing chromosome.
 
;Fluorescent in situ hybridization (FISH)<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>
:FISH is a specific molecular genetic method used to identify chromosomal abnormalities and other genetic changes in cells using special DNA probes labelled with fluorescent dyes. FISH can find small chromosomal changes like a rearranged chromosome.


===Bone Marrow Biopsy===
*[[Bone marrow biopsy]] is usually performed in most [[patients]] with a suspected [[diagnosis]] of [[multiple myeloma]] or other [[hematologic]] [[malignancy]]. It is usually done as part of the initial [[diagnostic]] workup.
*[[Bone marrow biopsy]] is usually performed to estimate the percentage of [[bone marrow]] occupied by [[plasma cells]].<ref name="canada">Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref>
*[[Bone marrow biopsy]] consists of both a liquid [[aspirate]] and a solid core [[biopsy]]. [[Immunophenotyping]] ([[flow cytometry]]) is usually done on the [[Bone marrow aspiration|bone marrow aspirate]] to assess for [[abnormal]] [[cells]]. Of note, [[plasma cells]] are particularly susceptible to mechanical damage by [[immunophenotyping]], so this is not the best way to assess for [[plasma cell]] burden in the [[Bone marrow|bone marrow.]] A better method is to assess the core [[biopsy]] for [[plasma cell]] content.
*[[Karyotyping]] detects any [[chromosomal]] abnormalities in [[multiple myeloma]] cells such as [[Chromosome 13 (human)|chromosome 13]] [[Deletion (genetics)|deletion]].<ref name="canada">Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref name="wiki">Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref> [[Cytogenetics]] ([[chromosome]] analysis) can be performed on the core [[biopsy]]. [[Molecule|Molecular]] studies are usually performed on the aspirate. Certain [[Cytogenetics|cytogenetic]] abnormalities have [[prognostic]] significance.
*The percentage of [[plasma cells]] is used of one of the key [[diagnostic criteria]] of [[multiple myeloma]].<ref name="canada">Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref> A [[diagnosis]] of [[multiple myeloma]] requires greater than 10% clonal [[Plasma cell|plasma cells]] in the [[bone marrow]].
*'''[[Fluorescent in situ hybridization]] (FISH)''' detects any [[chromosomal]] abnormalities occurring in [[multiple myeloma]] such as [[Chromosome 14 (human)|chromosome 14]] [[Translocations|translocation]].<ref name="canada">Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref name="wiki">Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 22:47, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2] Shyam Patel [3]

Overview

Bone marrow biopsy is an important diagnostic test in multiple myeloma. Bone marrow biopsy consists of the collection of the bone marrow aspirate and the solid core biopsy. Tests that can be performed on the bone marrow biopsy include karyotyping (chromosomal analysis) and immunophenotyping.

Other Diagnostic Studies

Bone Marrow Biopsy

References

  1. 1.0 1.1 1.2 1.3 Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  2. 2.0 2.1 Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015