Plasmacytoma diagnosis

All information given here is only of a general nature, tumor therapy always belongs in the hands of an experienced oncologist!

How is plasmacytoma diagnosed?

Diagnosis is difficult in some cases.
In most cases, only an increased blood sedimentation rate (ESR) is noticed at the beginning of the disease, which is caused by the defective protein proteins.
However, it must be expressly pointed out here that most of the increased blood sedimentation rates are due to inflammatory processes.

Often one uses the so-called Salmon and Durie criteriato make a diagnosis of plasmacytoma / multiple myeloma
These criteria include the following factors:

• the amount of blood pigment (Hb)
• the level of the serum - calcium - salary
• the level of protein content
• the number of plasma cells in the bone marrow
• the detection of Bence Jones protein in the urine
• the presence of too low an amount of normal defenses.

Multiple myelomas are divided into three stages. The classification depends on the amount of paraprotein that is (not) available Anemia and / or lack of platelets, levels of calcium in the blood and degrees of bone damage. A division into A (functioning well) and B (poorly functioning) is made depending on the kidney function.

The classification says something about the severity of the disease and the prognosis. In stage IA, therapy can be dispensed with, especially for older people. This is because treatment is not necessary for a given time and waiting for the situation to worsen will not do any harm. The drugs are then saved for when they are really needed, and the patient is not burdened with side effects of the treatment at an early stage. These recommendations are only general nature, every therapy must patient-specific become.

Stage I:

• HB> 10 g / dl
• Serum - calcium normal
• X-ray normal bones or at most one osteolytic focus
• low paraproteins:
  - IgG <5 g / dl
  - IgA <3 g / dl
  - Light chains in urine <4 g / 24 hours

All four criteria must be met.

Stage II:
Neither stage I nor stage III suitable.

Stage III:

• HB <8.5 g / dl
• Serum - calcium increased
• More than three osteolytic foci visible in the x-ray
• high paraproteins:
  - IgG> 7 g / dl
  - IgA> 5 g / dl
  - Light chains in the urine> 12 g / 24 hours

• X-rays of the skeleton to show osteolysis (bone damage). Typical areas are: thorax (rib cage), skull, spine, pelvic overview, shoulders, upper arms and thighs.

If an x-ray shows a change, the disease is already advanced. In order to detect osteolysis at an early stage, one can use a Nuclear spin tomography (magnetic resonance) carry out. It also shows early stages of bone changes.

Another method of early detection is skeletal intigraphy. With this method, an increased bone metabolism can also be detected in the early stages.

In addition to the above-mentioned plasmacytoma criteria according to Salmon and Durie, there are clinically oriented criteria:

• A content of more than 10% plasma cells in the bone marrow smear or histologically (= fine tissue) detected plasma cell infiltrates
• Detection of monoclonal antibodies called paraproteins in the blood or urine
• Evidence of osteolysis or general osteoporosis in more than 30% of plasma cells in the bone marrow.

If two of these criteria apply, one applies Plasmacytoma as secured.