Pathlogy Report: Ellen Palmer, Date collected 2/3/2000
SPECIMEN SOURCE: BONE MARROW
The specimen is received in two formalin filled containers each labeled with the patient's name.
Part 1 is labeled "aspirate" and consists of a 1 cm aggregate of brown clotted blood which is submitted in cassette number one.
Part 2 is consists of a brown sensigenous fragment of clotted blood, but no osseous material is identified. All tissue is submitted in cassette number two.
HISTORY: 58 year old female with history of multiple myeloma, pancytopenia.
CBC: Hgb 10.0, Hct 30.0, MCV 91.5, MCH 30.4, MCHC 33.2, WBC 900 with 28% neutrophils, 6%. bands, 44% lymphocytes, 12% monocytes, 5 eosinophils, 3% basophils, 2% reactive lymphs, 1% NRBC, platelet count 10,000
PERIPHERAL BLOOD SMEAR: The peripheral smear confirms the findings of pancytopenia. Platelets are markedly decreased. There is some tendency for rouleaux formation. Leukopenia is present although I do not visualize circulating plasma cells.
BONE MARROW ASPIRATE: One aspirate smear shows adequate quantity of marrow particles for exam. Cellularity is almost entirely composed of atypical plasma cell consistent with multiple myeloma. Allhematopoietic cell lines are markedly decreased, and while megakaryocytes are present, these are also numerically decreased in this sample. Plasma cell percentage exceeds 90%. . Myeloid and erythroid precursors are so scant that the presence or absence of dysplastic changes in these cell lines cannot be assessed in this sample.
BONE MARROW CLOT SECTION/CORE BIOPSY: These samples contain very scant material. A few minute marrow particles are present in each. These show essentially complete plasmocytic replacement as observed in the aspirate smears. The findings are consistent with multiple myeloma.
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