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Myeloma cells in the cerebrospinal fluid in plasma cell neoplasia
Abstract:
Myeloma cells were detected in the cerebrospinal fluid of two patients with plasma cell neoplasia during the myelographic studies of 38 patients whose myeloma was associated with extensive neurological complications. The myeloma cells were looked for in Wright stained centrifuged deposit of 2-5 ml samples of the cerebrospinal fluid obtained during myelography. The possibility that occult traumatic lumbar puncture had allowed entry of circulating myeloma cells from the peripheral blood into the subarachnoid space was excluded by the absence of myeloma cells in smears of peripheral blood and its buffy coat. Up to the end stages of the disease the meningeal myeloma lesions remained microscopical and no signs of raised intracranial tension were manifested by either patient.
Insights
Cerebrospinal fluid analysis revealed myeloma cells in two patients with neurological complications. These findings in plasma cell neoplasia highlight potential spread to the central nervous system.
Area of Science:
- Neurology
- Oncology
- Hematology
Background:
- Plasma cell neoplasia, including multiple myeloma, can present with diverse neurological complications.
- Cerebrospinal fluid (CSF) involvement in myeloma is not frequently documented, particularly in the context of neurological deficits.
Purpose of the Study:
- To investigate the presence and significance of myeloma cells in the cerebrospinal fluid of patients with multiple myeloma and neurological complications.
Main Methods:
- CSF samples (2-5 ml) were collected during myelography from 38 patients with myeloma and neurological issues.
- CSF cytology was performed using Wright-stained centrifuged deposits.
- Peripheral blood and buffy coat smears were examined to rule out contamination from lumbar puncture.
Main Results:
- Myeloma cells were identified in the CSF of two out of 38 patients.
- Absence of myeloma cells in peripheral blood smears excluded traumatic lumbar puncture as the source of CSF myeloma cells.
- Meningeal myeloma lesions remained microscopic, and no increased intracranial pressure was observed in the affected patients.
Conclusions:
- Detection of myeloma cells in CSF is possible in patients with plasma cell neoplasia and neurological complications.
- CSF cytology during myelography can aid in diagnosing meningeal involvement in myeloma.
- Microscopic meningeal lesions and absence of raised intracranial tension can occur even with CSF myeloma cell presence.