Variant morphology in multiple myeloma

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Multiple myeloma is a plasma cell malignancy.
• Accurate diagnosis relies on integrating various clinical and laboratory findings.

Observation:

• A 45-year-old male presented with low back pain, significant weight loss, and pallor.
• Initial laboratory results revealed severe normocytic anemia and leukoerythroblastosis.
• Bone marrow aspirate yielded a dry tap, and trephine biopsy showed poorly differentiated cells.

Findings:

• Immunohistochemistry and protein studies confirmed IgG Kappa multiple myeloma.
• The initial biopsy findings were misinterpreted as poorly differentiated carcinoma.

Implications:

• This case highlights the importance of a multidisciplinary approach in diagnosing multiple myeloma.
• Accurate interpretation of bone marrow pathology, combined with clinical, radiological, and immunological data, is essential.