A 70 years old male presented with severe intractable diarrhea. His bone marrow and renal biopsy was done which is as shown below. What is the most appropriate diagnosis?
A. Multiple myeloma
C. Urate nephropathy
Answer-A. Multiple myeloma
- Malignant proliferation of plasma cells in the bone marrow results in the production of large number of complete and incomplete immunoglobulins.
- Classic triad of multiple myeloma: Marrow plasmacytosis + Lytic bone lesions Serum and/or urine M component
- Hypercalcemia is MC cause of renal failure in multiple myeloma
- Renal damage is also contributed by Bence Jones proteinuria (directly toxic to tubular cells), cast nephropathy & amyloidosis
- Microscopic examination shows increased number of plasma cells (>30 % of marrow cellularity)