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?
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)