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Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma

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Light-Chain Multiple Myeloma: A Diagnostic Challenge.

Cristina Silva¹, Ana Costa¹, David Paiva¹

¹Internal Medicine, Hospital Senhora da Oliveira, Guimarães, PRT.

|December 6, 2021

Summary

Light-chain multiple myeloma (LCMM) is a rare, aggressive plasma cell cancer. Early diagnosis of this condition, characterized by excess light chains, is crucial for timely treatment and improved patient outcomes.

Keywords:

anemia free light chains lytic bone lesion multiple myeloma renal insufficiency

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Area of Science:

Hematology
Oncology

Background:

Light-chain multiple myeloma (LCMM) is a rare subtype of multiple myeloma (MM).
LCMM is characterized by the exclusive production of immunoglobulin light chains by malignant plasma cells, lacking heavy chain synthesis.
This unique pathophysiology results in the absence of a detectable M-spike on serum protein electrophoresis, complicating diagnosis.

Observation:

A 67-year-old female presented with anemia, severe renal insufficiency, and multiple lytic bone lesions.
Diagnostic workup revealed elevated serum and urinary kappa light chains.
Bone marrow aspirate confirmed 21.7% atypical plasma cells, leading to a diagnosis of kappa light chain multiple myeloma.

Findings:

The patient was diagnosed with kappa light chain multiple myeloma.
Elevated kappa light chains in serum and urine were key diagnostic markers.
Bone marrow biopsy confirmed the presence of atypical plasma cells.

Implications:

Rapid diagnosis of LCMM is critical for prompt management.
Early referral to specialized centers facilitates timely treatment initiation.
Aggressive management strategies are essential for improving prognosis in LCMM patients.