Bloody Minded Episode 24 - Blue Fried Eggs | Intro to Multiple Myeloma
Nov 19, 2024
Dive into the world of multiple myeloma as the hosts unravel its complex nature with a blend of humor and education. Learn about precursor stages like MGUS and discover how rouleaux formation affects blood analysis. They also tackle the intricacies of diagnosing multiple myeloma, including the significance of bone marrow biopsies and evolving diagnostic criteria. With a clinical case study to illustrate concepts, the conversation is both enlightening and engaging, making a serious topic accessible.
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Essential Myeloma Investigations
- When myeloma is suspected, order serum-free light chain assay, EPG, IEPG, beta-2 microglobulin, and LDH tests.
- Add calcium tests and anemia workup including blood film and viral serologies for comprehensive investigation.
Rouleaux Formation Explained
- Rouleaux formation in blood films reflects altered protein balance causing red cells to stack like coins.
- This is common in myeloma but can appear in other protein-increasing conditions like high CRP or rheumatoid factor.
Blue Fried Eggs of Plasma Cells
- Normal plasma cells in bone marrow appear as blue fried eggs under microscope with blue cytoplasm and eccentrically placed nucleus.
- Myeloma cells alter this appearance and increase plasma cell count beyond normal 5%.