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A comprehensive review of the impact of obesity on plasma cell disorders.

Multiple myeloma (MM) remains an incurable plasma cell malignancy. Although little is known about the etiology of MM, several metabolic risk factors such as obesity, diabetes, poor nutrition, many of which are modifiable, have been linked to the pathogenesis of numerous neoplasms including MM. In this article, we provide a detailed summary of what is known about the impact of obesity on the pathogenesis of MM, its influence on outcomes in MM patients, and discuss potential mechanisms through which obesity is postulated to influence MM risk and prognosis. Along with advancements in treatment mo

A Rare Case of Plasma Cell Leukemia Presenting as Dyspnea.

A 74-year-old man presented to the ED with acute chronic exertional dyspnea of 5-day duration. As part of his previous evaluation, 5 months earlier, he had undergone cardiopulmonary stress testing, routine laboratory evaluation, and chest radiography that were unremarkable. Over the subsequent months, he had waxing and waning exercise capacity until his incident hospitalization; the exercise was limited to < 40 meters. He reported associated nonproductive cough, 15-pound unintentional weight loss over the past 5 months, night sweats, easy fatigability, and early satiety. A chest radiograph was

[PAX5-positive plasma cell leukemia presenting as lymphocytosis].

An 82-year-old Japanese male patient was initially diagnosed with lymphocytosis. His complete blood count revealed a white blood cell count of 30.9×109/l with 81% abnormal lymphocytes. The abnormal lymphocytes included monoclonal clones of CD38+ and CD138+cytoplasmic κ+ and IgG-κ M-protein, which led to the final diagnosis of plasma cell leukemia (PCL). Bortezomib and dexamethasone therapy was initiated, but the patient succumbed to the disease on the 8th day of hospitalization. A cytogenetic examination revealed a t (9;14)(p13;q32) translocation and the Western blotting confirmed high PAX5 ex

Imaging for Plasma Cell Dyscrasias: What, When, and How?

Imaging plays a vital role in the diagnosis, response assessment, and follow-up of patients with plasma cell bone disease. The radiologic diagnostic paradigm has thus far evolved with developing technology and availability of better imaging platforms; however, the skewed availability of these imaging modalities in developed vis-à-vis the developing countries along with the lack of uniformity in reporting has led to a consensus on the imaging criteria for diagnosing and response assessment in plasma cell dyscrasia. Therefore, it is imperative for not only the radiologists but also the treating

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… marrow plasma cells ≥10% (but less than 60%), or serum M protein ≥30 g/dl | Clonal bone marrow plasma cells less than 10% Colloquially referred to as the “SLiM CRAB”: | | Serum M protein less than 30 g/dl S ixty percent or more clonal bone marrow plasma cells. … Table 7 Differential diagnosis for imaging features of various plasma cell dyscrasias. …

Plasma cell gingivitis: A perplexing and rare clinical entity.

Plasma cell gingivitis (PCG) is a diagnostic dilemma for clinicians. It is also referred to as atypical gingivostomatitis, idiopathic gingivostomatitis, allergic gingivostomatitis, and plasma cell gingivostomatitis which are characterized by bright fiery red gingiva with spontaneous bleeding on slight provocation. It is often confused with inflammatory gingival enlargement, erythematosus lichen planus, and other lesions. One such rare and benign entity is discussed in this article and managed after thorough clinical, radiological, histopathology, immunohistochemistry analysis.

Plasma cell neoplasms of the bladder: a series of 9 cases.

From 2009 to 2017, we identified 9 cases of plasma cell neoplasms on biopsies of the bladder in patients without a history of plasma cell my … one marrow biopsy results were obtained in the 2 amyloid cases revealing a population of 5% or less plasma cells with no assessment of clonality and, thus, were not diagnostic of plasma cell myeloma. In congruence, the 2 amyloid cases also showed no radiologic evidence of systemic plasma cell myeloma. One patient with plasma cell neoplasm only received chemoth …

Pulmonary Vascular Disease Due to Plasma Cell Dyscrasia.

Pulmonary hypertension (PH) has been described in myeloproliferative disorders; monoclonal plasma cell disorder such as polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome; and plasma cell dyscrasias such as multiple myeloma and amyloidosis. We describe 4 cases of PH likely due to pulmonary vascular involvement and myocardial deposition from light chain deposition disease, amyloidosis, and multiple myeloma. On the basis of our clinical experience and literature review, we propose screening for plasma cell dyscrasia in patients with heart failure with

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… cells 20% monoclonal plasma cells 30% monoclonal plasma cells 10%-15% monoclonal plasma cells 90% plasma cells Congo red stain Negative Negative Negative Not performed Endomyocardial biopsy Not done Not done Congo red–positive deposits Mass spectrometry: AL (lambda) type Not performed Renal biopsy Global … cells | 20% monoclonal plasma cells | 30% monoclonal plasma cells | 10%-15% monoclonal plasma cells | 90% plasma cells Congo red stain | Negative | Negative | Negative | Not performed Endomyocardial biopsy | Not done | Not done | Congo red–positive deposits Mass spectrometry: AL (lambda) type | Not …

Evaluation of plasma cell mastitis with superb microvascular imaging.

BACKGROUND: Plasma cell mastitis (PCM), a common type of mastitis often mimics malignancy clinically and radiologically. OBJECTIVE: The study was designed to explore the diagnostic value of superb microvascular imaging (SMI) in differentiating PCM from malignant breast lesions. METHODS: A total of 95 breast lesions underwent conventional ultrasound (US) and SMI examination between May 2016 and April 2018. Vessels were detected in SMI in a quantitative manner. Blood flow parameters including systolic peak velocity (SPV), resistance index (RI), and pulsatility index (PI) were evaluated. We fur

Plasma Cell Granuloma of the Thyroid: Review of an Uncommon Entity.

Plasma cell granuloma (PCG) is characterized by proliferation of polyclonal plasma cells with associated fibrosis and is often considered part of the heterogeneous group of inflammatory myofibroblastic tumors (IMTs). The thyroid is rarely affected by PCG. A patient having PCG associated with Hashimoto thyroiditis (HT) prompted our literature search that revealed 18 cases of PCG, 55% (n = 10) of which occurred together with HT. The etiopathogenesis of PCG is unknown and there is no specific treatment except surgical excision for compressive symptoms. This entity has an excellent prognosis with …

Quantification of plasma cell dynamics using mathematical modelling.

Plasma cells (PCs) are the main antibody-producing cells in humans. They are long-lived so that specific antibodies against either pathogens or vaccines are produced for decades. PC longevity is attributed to specific areas within the bone marrow micro-environment, the so-called 'niche', providing the cells with required growth and survival factors. With antigen encounters, e.g. infection or vaccination, new PCs are generated and home to the bone marrow where they compete with resident PCs for the niche. We propose a parametrized mathematical model describing healthy PC dynamics in the bone ma…

The use of emergency apheresis in the management of plasma cell disorders.

Hyperviscosity syndrome (HVS) develops most commonly in Waldenström's macroglobulinemia (WM) and multiple myeloma (MM). Plasmapheresis is the immediate therapy and very effective at relieving symptoms by removing paraprotein. The most commonly used replacement fluid is 4%-5% human albumin in physiologic saline. FFP may be used in patients with coagulation abnormalities. Plasmapheresis should be continued until acute symptoms abate. Hyperviscosity impairs the circulation in the retina and causes hemorrhages around the small retinal vessels. Early diagnosis and urgent plasmapheresis may reduce b

Abnormal Plasma Cell Disorders in Refinery Waste Workers.

A monoclonal gammopathy of undetermined significance (MGUS) may develop into a multiple myeloma or a correlated lymphoproliferative malignancy with a progress rate of 1% per year. The immune status, occupational-environmental risk factors, and hereditary factors may influence the risk of developing MGUS. We investigated the prevalence of MGUS in 77 refinery waste workers. They were all males, averagely aged 36, with a mean working history of 18.5 years and working in the dump for about 4.2 years. After analyzing the results of standard serum electrophoresis migrations, 16% of cases (n = 12) sh