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==Overview==
==Overview==
Cytology and/or histology, cytogenetic investigation (chromosome analysis and FISH) may be helpful in the diagnosis of multiple myeloma to detect unfavorable cytogenetic aberrations.<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> PMID:27476706 On bone marrow biopsy, multiple myeloma is characterized by an increase in percentage of abnormal 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> On genetic testing, multiple myeloma is characterized by chromosome 13 deletion and chromosome 14 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>
[[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]].


==Other Diagnostic Studies==
==Other Diagnostic Studies==


===Bone Marrow Biopsy===
===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 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]] 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 biology. Immunophenotyping (flow cytometry) is usually done on the 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. A better method is to assess the core biopsy for plasma cell content.
*[[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 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. Molecular studies are usually performed on the aspirate. Certain cytogenetic abnormalities have prognostic significance.  
*[[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 cells in the bone marrow.
*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 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>
*'''[[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