Background: Multiple myeloma is a malignant plasma cell dyscrasia which is characterised by bone marrow plasmacytosis. Multiple myeloma causes 1 % of all cancer deaths in western population.

Objectives

1. To describe the various morphological types of myeloma in bone marrow examination and its  kappa and lambda expression
2. To assess the microvessel density using CD 34 in the bone marrow biopsy of patients with multiple myeloma

Methods

Study Design: Descriptive study

Study Population: Study sample includes all the cases of multiple myeloma received in the Department  of Pathology during the study period.

Sample Size: 64

Sampling Procedure: Continuous sampling

Results: In our study, myeloma with plasma cell morphology constituted 57.82% and plasmablastic morphology constituted 42.18 %. A high microvessel density above the cut off value was seen in 28 cases (43.75 %) and a low MVD in 36 cases (56.25 %).In all the cases monoclonality was proved by kappa and lambda light chain restriction. In the present study, plasmablastic morphology was found to have a higher microvessel density compared to plasmacytic type. It was also suggested that a higher microvessel density was seen in cases with plasma cell percentage of more than 50 % and diffuse plasma cell infiltration in the bone marrow.

Conclusion: Statistically significant association was detected between microvessel density and the plasma cell morphology. Microvessel density was found to be higher with plasma cell morphology.

Keywords: Multiple myeloma; microvessel density (MVD); kappa and lambda.

1. N, Kataria. S.P, S. Malik, N.Sharma and S. Kumar; Histopathological Spectrum of Central Nervous System Tumours in a tertiary care referral centre- A one year study. International Journal of Basic and Applied Medical Sciences. 2014;4(2):141-145.
2. Nibhoria S, KaurTiwana K, Phutela R, Bajaj A, Chhabra S. Histopathological Spectrum of Central Nervous System Tmours: A single centre study of 100 cases. International Journal of Scientific Study, 2015;p 130- 134. 2015;3(6):130- 134.
3. Louis D. WHO classification of tumours of the central nervous system. Lyon: International Agency for Research on Cancer; 2016.
4. A. Elsers and Noha. A. Aboulhagag; Expression of Ki-67, EGFR and its ligand in different grades of Meningiomas; AAMJ, 2012; p 34-56.
5. Scholzen T, Gerdes J. The Ki-67 protein: From the known and the unknown. Journal of Cellular Physiology. 2000;182(3):311-322
6. Drake R, Vogl W, Mitchell A, Gray H. Gray's anatomy for students. Philadelphia, PA: Churchill Livingstone/Elsevier; 2010.
7. Young B, O'Dowd G, Woodford P. Wheaters functional histology. 6th ed. Philadelphia: Reed Elsevier; 2014: 384-401
8. Sengupta S, Banerjee U, Chatterjee S, Chatterjee U, Ghosh S, Ghosh A. A study of histopathological spectrum and expression of Ki-67, TP53 in primary brain tumors of pediatric age group. Indian Journal of Medical and Paediatric Oncology. 2012;33(1):25.
9. Aryal G. Histopathological pattern of central nervous system tumor: A three year retrospective study. Journal of Pathology of Nepal. 2011;1(1):22-25.
10. Alomar S. Clinical manifestation of central nervous system tumor. Seminars in Diagnostic Pathology. 2010;27(2):97-104.
11. Harnsberger H, Dillon W. Imaging Tumors of the Central Nervous System and Extracranial Head and Neck. CA: A Cancer Journal for Clinicians. 1987;37(4):225-238.
12. Essig M, Anzalone N, Combs S, Dörfler A, Lee S, Picozzi P et al. MR Imaging of Neoplastic Central Nervous System Lesions: Review and Recommendations for Current Practice. American Journal of Neuroradiology. 2011;33(5):803-817.

Sheeja S

Associate Professor, Department of Pathology, Govt. Medical College Kottayam, India