Multiple myeloma differential diagnosis: Difference between revisions
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*The table below summarizes how to differentiate multiple myeloma from other conditions that cause similar presentation:<ref name="seer">{{Cite web | last = | first = | title = Myeloma - SEER Stat Fact Sheets | url = http://seer.cancer.gov/statfacts/html/mulmy.html | publisher = | date = | accessdate = 17 February 2014 }}</ref> | *The table below summarizes how to differentiate multiple myeloma from other conditions that cause similar presentation:<ref name="seer">{{Cite web | last = | first = | title = Myeloma - SEER Stat Fact Sheets | url = http://seer.cancer.gov/statfacts/html/mulmy.html | publisher = | date = | accessdate = 17 February 2014 }}</ref> | ||
{| {{table}} | {| {{table}} cellpadding="4" cellspacing="0" style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" | ||
| align="center" style="background:#4479BA;"|'''Plasma Cell Neoplasm''' | | align="center" style="background:#4479BA;" |'''Plasma Cell Neoplasm''' | ||
| align="center" style="background:#4479BA;"|'''M Protein Type''' | | align="center" style="background:#4479BA;" |'''M Protein Type''' | ||
| align="center" style="background:#4479BA;"|'''Pathology''' | | align="center" style="background:#4479BA;" |'''Pathology''' | ||
| align="center" style="background:#4479BA;"|'''Clinical Presentation''' | | align="center" style="background:#4479BA;" |'''Clinical Presentation''' | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | MGUS|| style="padding: 5px 5px; background: #F5F5F5;" |IgG kappa or lambda; or IgA kappa or lambda|| style="padding: 5px 5px; background: #F5F5F5;" |<10% [[plasma cells]] in bone marrow|| style="padding: 5px 5px; background: #F5F5F5;" |Asymptomatic, with minimal evidence of disease (aside from the presence of an M protein) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | MGUS|| style="padding: 5px 5px; background: #F5F5F5;" |IgG kappa or lambda; or IgA kappa or lambda|| style="padding: 5px 5px; background: #F5F5F5;" |<10% [[plasma cells]] in bone marrow|| style="padding: 5px 5px; background: #F5F5F5;" |Asymptomatic, with minimal evidence of disease (aside from the presence of an M protein) | ||
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:* Reactive plasmacytosis | :* Reactive plasmacytosis | ||
:* [[Macroglobulinemia]] | :* [[Macroglobulinemia]] | ||
:* [[Osteoporosis]] (osteoporotic [[fracture]]) | |||
==References== | ==References== | ||
Revision as of 12:42, 31 August 2017
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Multiple myeloma Microchapters |
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Multiple myeloma differential diagnosis On the Web |
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American Roentgen Ray Society Images of Multiple myeloma differential diagnosis |
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Risk calculators and risk factors for Multiple myeloma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
Multiple myeloma must be differentiated from monoclonal gammopathy of undetermined significance (MGUS), isolated plasmacytoma of the bone, and extramedullary plasmacytoma.[1]
Differentiating Multiple Myeloma from other Diseases
- The table below summarizes how to differentiate multiple myeloma from other conditions that cause similar presentation:[1]
| Plasma Cell Neoplasm | M Protein Type | Pathology | Clinical Presentation |
| MGUS | IgG kappa or lambda; or IgA kappa or lambda | <10% plasma cells in bone marrow | Asymptomatic, with minimal evidence of disease (aside from the presence of an M protein) |
| Isolated plasmacytoma of bone | IgG kappa or lambda; or IgA kappa or gamma | Solitary lesion of bone; <10% plasma cells in marrow of uninvolved site | Asymptomatic or symptomatic |
| Extramedullary plasmacytoma | IgG kappa or lambda; or IgA kappa or gamma | Solitary lesion of soft tissue in the nasopharynx, tonsils, or sinuses | Asymptomatic or symptomatic |
| Multiple myeloma | IgG kappa or lambda; or IgA kappa or gamma | Often multiple lesions of bone | Symptomatic |
- Another important differential diagnosis is that of widespread bony metastases. Findings that favor the diagnosis of bony metastases over that of multiple myeloma include:[2]
- Bone metastases more commonly affect the vertebral pedicles rather than vertebral bodies.
- Bone metastases rarely involve mandible and distal axial skeleton.
- Although both entities have variable bone scan appearances (both hot and cold) unlike multiple myeloma, extensive bony metastases rarely have a normal appearance.
- Multiple myeloma must also be differentiated from other causes of bone pain and fatigue such as:
- Waldenstrom Hypergammaglobulinemia
- Bone fracture
- Fibrous dysplasia
- Enchondroma
- Eosinophilic granuloma
- Giant cell tumor
- Osteoblastoma
- Aneurysmal bone cyst
- Solitary bone cyst
- Hyperparathyroidism
- Infection
- Chondroblastoma
- Chondromyxoid Fibroma
- Reactive plasmacytosis
- Macroglobulinemia
- Osteoporosis (osteoporotic fracture)
References
- ↑ 1.0 1.1 "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
- ↑ Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015