MULTIPLE MYELOMA

🔹Most common primary neoplasm of skeletal system.

  • A disease of bone marrow
  • A malignancy of plasma cells
  • Monoclonal malignancies

🔹Clinical Features:

  1. Age: 60 – 65 years
  2. Sex: M>F
  3. Site: Vertebra, Ribs, Skull, Pelvis, Femur bone.
  4. Symptom: Bone pain (due to compression fractures)
  5. Signs:
  • Lytic bone lesions
  • Anemia
  • Azotemia
  • Hypercalcaemia
  • Recurrent infection

🔹Oral Manifestations:

  1. Jaw: Mandible>Maxilla
  2. Site: Ramus & Angle of mandible at Molar area
  3. Signs:
  • Intraosseous
  • Pain
  • Swelling
  • Numbness
  • Mobility of teeth
  • Extraosseous one’s resemble epulis/gingival enlargement.

🔹Radiographic features: Punched out areas

🔹 Lab. findings:

  1. Hyperglobulinemia
  2. Bence Jones protein in urine – Also seen in leukemia, polycythemia
  3. ⬆️ ESR
  4. ⬆️ Alkaline phosphatase
  5. Hyperuricemia

🔹Histological Features:

1. Cells are closely packed in large sheets..👇🏻

  • Round/Ovoid
  • Nuclei – eccentric placed
  • Chromatin clumping in a cart wheel/checkerboard pattern
  • Perinuclear halo (Golgi complexes)

2. Russell bodies: Russell bodies are multiple round cytoplasmic hyaline inclusions that are frequently seen in bone marrow aspirates in myeloma. They are composed of immunoglobulin molecules within vesicular structures derived from rough endoplasmic reticulum. Plasma cells containing them are sometimes referred to as Mott cells.

🔹Treatment:

  1. Bisphosphonate therapy
  2. Chemotherapy

References: Shafer’sTextbook Of Oral Pathology


Dr. Mehnaz Memonđź–Š

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s