Triangular approach for the diagnosis of monoclonal gammopathy in malignancies

Monoclonal Gammopathy (MG) in multiple myeloma (MM) is an established association but its occurrence in nonmyelomatous malignancies and other inflammatory conditions is still a subject of research. We carried out this study to detect monoclonal gammopathy in myelomatous and nonmyelomatous malignancies by adopting the triangular approach of correlating radiologic findings, bone marrow studies and electrophoretic findings. 200 cases of malignancies (25 cases of multiple myeloma and 175 cases of nonmyelomatous malignancies) were studied. Serum and urine electrophoresis was carried out in every case and positive cases were subjected for typing by immunoelectrophoresis (IEP). The incidence of monoclonal gammopathy in nonmyelomatous malignancies was 2.29% (4/175 cases), in epithelial malignancies was 0.8% (1/125 cases) and 6% (3/50 cases) in haematological malignancies. Though the study sample was small, these interesting findings warrant more exhaustive research in this field.