Saqib Qayyum Ahmad, Khalil Ullah, Mansoor Tahir, Abdul Qayyum.
Role of Fine Needle Aspiration Biopsy in the diagnosis of Multiple Myeloma.
J Coll Physicians Surg Pak Jan ;12(6):384-6.

Bone marrow biopsy is routinely carried out in patients suspected to be suffering from multiple myeloma to look for marrow plasmacytosis. In those patients in whom lytic bone lesions are also present, fine needle aspiration biopsy of the lytic bone lesions may be done to document marrow plasmacytosis. A patient in whom this procedure has been done to document the marrow pathology is reported here.

A 50-year-old male presented with history of generalized weakness, pain and pallor of 5-month duration. There was no history of fever, weight loss or bleeding from any site. On examination he was of average build, conscious and oriented, afebrile, normotensive but looked pale. There was no jaundice, lymphadenopathy, skin bruises, or palpable hepatosplenomegaly. Examination of cardiovascular, respiratory and central nervous systems did not reveal any gross abnormality. His haemoglobin was 6 g/dl (reference range: 13-15.5 g/dl), total leukocyte count was 8.3 x 10e9/1 (reference range: 4-10.5 x 10e9/l) with neutrophils 59%, lymphocytes 35%, monocytes 01%, eosinophils 5% and the platelet count 310x10e9/l (reference range: 150-400 x 10e9/1). Erythrocyte sedimentation rate (ESR) was 140 mm at the end of first hour and red cell morphology was normocytic normochromic with marked rouleaux formation. Serum urea and creatinine were 10.9 mmol/l (reference range: 3.3-6.7 mmol/l) and 190.6 mmol/l (reference range: 60-138 mmol/l) respectively. Chest roentgenogram showed multiple lytic lesions in the ribs with a prominent expansile lesion on the left 9th rib.

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