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Diseases » Multiple Myeloma » Diagnosis

Diagnosis of Multiple Myeloma

Diagnostic Test list for Multiple Myeloma:

The list of medical tests mentioned in various sources as used in the diagnosis of Multiple Myeloma includes:

Multiple Myeloma Diagnosis: Book Excerpts

Tests and diagnosis discussion for Multiple Myeloma:

Multiple myeloma may be found as part of a routine physical exam before patients have symptoms of the disease. When patients do have symptoms, the doctor asks about their personal and family medical history and does a complete physical exam. In addition to checking general signs of health, the doctor may order a number of tests to determine the cause of the symptoms. If a patient has bone pain, x-rays can show whether any bones are damaged or broken. Samples of the patient's blood and urine are checked to see whether they contain high levels of antibody proteins called M proteins . The doctor also may do a bone marrow aspiration and/or a bone marrow biopsy to check for myeloma cells. In an aspiration, the doctor inserts a needle into the hip bone or breast bone to withdraw a sample of fluid and cells from the bone marrow. To do a biopsy, the doctor uses a larger needle to remove a sample of solid tissue from the marrow. A pathologist examines the samples under a microscope to see whether myeloma cells are present.

To plan a patient's treatment, the doctor needs to know the stage, or extent, of the disease. Staging is a careful attempt to find out what parts of the body are affected by the cancer. Treatment decisions depend on these findings. Results of the patient's exam, blood tests, and bone marrow tests can help doctors determine the stage of the disease. In addition, staging usually involves a series of x-rays to determine the number and size of tumors in the bones. In some cases, a patient will have MRI if closeup views of the bones are needed. (Source: excerpt from What You Need To Know About Multiple Myeloma: NCI)

Diagnostic Tests for Multiple Myeloma: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about diagnostis of Multiple Myeloma.

Multiple myeloma: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

CONFIRMING DIAGNOSIS After a physical examination and a careful medical history, the following diagnostic tests and nonspecific laboratory abnormalities confirm the presence of multiple myeloma:

❑Bone marrow aspiration and biopsy detects myelomatosis cells (abnormal number of immature plasma cells).

❑Urine studies may show Bence Jones protein and hypercalciuria. Absence of Bence Jones protein doesn't rule out multiple myeloma; however, its presence almost invariably confirms the disease. (See Bence Jones protein.)

❑Complete blood count shows moderate or severe anemia. The differential may show 40% to 50% lymphocytes but seldom more than 3% plasma cells. Rouleau formation (usually the first clue) seen on differential smear results from elevation of the red cell sedimentation rate.

❑Serum electrophoresis shows elevated globulin spike that's electrophoretically and immunologically abnormal.

❑ X-rays during early stages may show only diffuse osteoporosis. Eventually, they show multiple, sharply circumscribed osteolytic (punched out) lesions, particularly on the skull, pelvis, and spine — the characteristic lesions of multiple myeloma.

❑ Excretory urography can assess renal involvement. To avoid precipitation of Bence Jones protein, iothalamate or diatrizoate is used instead of the usual contrast medium and, although oral fluid restriction is usually the standard procedure before excretory urography, patients with multiple myeloma receive large quantities of fluid, generally orally but sometimes I.V., before excretory urography is done.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Multiple Somatic Complaints: Differential Overview
(Field Guide to Bedside Diagnosis)

❑ Anxiety

❑ Depression

❑ Hypothyroidism

❑ Premenstrual syndrome

❑ Hypochondriasis

❑ Somatization disorder

❑ Chronic fatigue syndrome

❑ Fibromyalgia

❑ Panic disorder

❑ Malingering

❑ Conversion reaction

Diagnostic Approach

This presentation is marked by multiple vague complaints, symptoms out of proportion to the physical findings, symptoms outside the anticipated spectrum of the organic disease, and symptoms that do not follow anatomic distributions. The patient is often more concerned with the physician accepting authenticity of symptoms than relieving them. Vague, diffuse descriptions or overly detailed and elaborate symptoms are suggestive. The patient seems to be amplifying normal bodily sensations. Psychological factors may be revealed in the symbolic choice of words (e.g., “lump in the throat”).

“Stress” for most patients is an acceptable framework within which to obtain psychological information. Care must be taken during the interview not to suggest that the symptoms are “all in the head.”

A thorough and thoughtful history and physical examination are the basis for chosing specific diagnostic tests, and signal to the patient that the complaints are being taken seriously.

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007