The histologic features of the plasma cells in multiple myeloma correlate with patient survival.
Dysplastic features in plasma cells:
(1) increased nuclear-to-cytoplasmic ratio
(2) distinct central nucleoli and dispersed nuclear chromatin
(3) multinucleation
Features of plasmablasts:
(1) prominent nucleoli
(2) enlarged nuclei
(3) high nuclear-to-cytoplasmic ratio
Dysplasia
Findings
Survival
none or minimal
Most of the plasma cells mature.
None or slight nuclear/cytoplasmic dyssynchrony.
Nucleolated or dysplastic plasma cells make up <10% of tumor cells.
Mitotic figures are rare (<1 per 10 high powered fields).
32.9 months
moderate
Nucleolated or dysplastic plasma cells make up 10-50% of tumor cells.
Mitotic figures are 1-9 per 10 high powered fields.
25.2 months
marked
Plasmablasts and/or dysplastic plasma cells make up >50% of tumor cells.
>= 1 mitotic figure per high powered field.
12.9 months
Additional prognostic findings
Estimated Survival
packing of marrow by tumor
15.2 months
mitoses >= 5 per high powered field
11 months
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Specialty: Hematology Oncology
