Age/sex: 64-year-old male
Size: 19.8 x 14.2 x 7.0 cm
The specimen consists of the lower thoracic and upper lumbar vertebrae cut to show the cauda equina (C) and the terminal portion of the spinal cord (T). The bodies of three thoracic vertebrae are collapsed (short arrows) resulting in bending of the spine (kyphosis). A relatively discrete necrotic tumor is present in a fourth vertebra (long arrow).
Plasma cell myeloma
Myeloma is a malignant tumor (cancer) of white blood cells that resemble normal plasma cells. The latter are mature B cells whose main function is to produce antibodies for defense against infectious organisms. Their cytoplasm contains abundant endoplasmic reticulum (where the antibodies are formed) and a prominent paranuclear Golgi apparatus (for antibody secretion outside the cell).
Myeloma cells can be present diffusely in the bone marrow or can grow in clusters to form macroscopic tumors (such as the focus in the fourth vertebra of this specimen). On radiologic imaging they can be seen as 鈥減unched out鈥� spaces in the bones. Bone pain, bleeding, and recurrent infections are typical clinical features. The cancer usually develops in older individuals and often progresses over a few years to death (5-year survival is about 35% with current types of chemotherapy).
Below: This radiograph of a forearm shows numerous lytic (鈥減unched out鈥�) areas caused by myeloma cell tumors that have replaced normal bone.
Source: Hellerhoff. (2010). Multiple myeloma: X-ray with multiple osteolytic lesions in the forearm. Wikimedia Commons.
