OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press63810.17650/1818-8346-2007-0-2-10-15DIAGNOSIS OF HEMATOLOGIC MALIGNANCIESДИАГНОСТИКА ГЕМОБЛАСТОЗОВPitfalls in the pathological diagnosis of multiple myelomaТрудности морфологической диагностики множественной миеломыBaykovV. V.БайковВ. В.
Russian Federation

St Petersburg 

Санкт-Петербург

St Petersburg Pavlov state medical universityСанкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова230520072101523112022231120222007https://oncohematology.abvpress.ru/ongm/article/view/638

During 1999-2006, a total of 350 trephine biopsy specimens were evaluated in our department for presence of multiple myeloma. The diagnosis of plasma cell neoplasm was made in 148 cases. In 30% of specimens plasma/myeloma cell count was below 30%, and in 7% - below 10%. Giemsa staining improved detectability of plasma cells. In cases with low plasma cell count immunohistochemistry for CD138 and Ig light chains was able to pick out neoplastic cells and to confirm monoclonality, therefore it was a useful adjunct for morphologic diagnosis. Difficulties in morphological evaluation of trephine biopsies are discussed. It is concluded that the diagnosis of multiple myeloma is based on clinical, laboratory and morphologic data.

В течение 1999—2006 гг. в нашей лаборатории исследовано около 350 трепанобиоптатов больных множественной миеломой (ММ) и пациентов с подозрением на ММ. Наличие опухоли подтверждено морфологически у148 больных. У трети больных миеломные клетки по результатам обзорных исследований составляли менее 30%, а у 7% — менее 10% всех миелокариоцитов. У этих больных диагноз ММ был поставлен при иммуногистохимическом исследовании. Выявление CD138 и легких цепей иммуноглобулинов позволяет оценить истинное содержание и локализацию плазматических/миеломных клеток в костном мозге, а также их клональное происхождение. Обсуждаются трудности диагностики миеломной болезни по трепанобиоптатам.

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