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- Title
The Role of Bone Marrow Biopsy Evaluation in the Workup for Monoclonal Gammopathy of Renal Significance.
- Authors
Metcalf, Brandon D.; Huang, James; Kanaan, Hassan D.; Abukhaled, Jamal; Wei Li; Samarapungavan, Dilip; Zarouk, Sami; Zhang, Ping L.
- Abstract
Context.--Monoclonal gammopathy of renal significance (MGRS) is a relatively new concept for patients with renal monoclonal protein deposition (RMPD) (except monoclonal cast nephropathy) and has been used as a reason for nephrologists to obtain a bone marrow biopsy (BMB). It takes a team of pathologists and clinicians to determine when RMPD at our institution can be defined as MGRS. Objective.--To identify the proportion of various subtypes of tentative MGRS diagnosed by renal biopsy that can be confirmed as final MGRS after BMB. Design.--One hundred thirty kidney biopsies with variants of RMPD were identified during the past 10 years. Biopsy cases with known myeloma, B-cell lymphoma, or monoclonal cast nephropathy were separated as a heavy-burden group. The remaining biopsies with RMPD were considered tentative MGRS. Their BMB and clinical indices were further analyzed to determine the final percentage of MGRS diagnoses. Results.--Among the 130 renal paraprotein deposition cases, 44 (33.8%) were categorized as the heavy-burden group. In the remaining 86 cases, 33 (38.4%) with subsequent identification of myeloma (.10% of monoclonal plasma cells) or lymphoma in BMB were further considered as heavy-burden cases. Eighteen cases (18 of 86; 20.9%) did not receive follow-up BMB; thus, no further analysis was performed. BMBs diagnosed as either nonmalignant (no plasma cells; 8 of 86 cases; 9.3%) or premalignant (,10% plasma cells; 27 of 86 cases; 31.4%) were confirmed to be final MGRS (35 of 86; 40.7%). Conclusions.--The data indicate that BMB is an important element in the confirmation of MGRS.
- Subjects
MICHIGAN; BONE marrow examination; BIOPSY; PARAPROTEINEMIA; MULTIPLE myeloma; CREATININE; RETROSPECTIVE studies; DESCRIPTIVE statistics; GLOMERULONEPHRITIS; KIDNEYS; B cell lymphoma
- Publication
Archives of Pathology & Laboratory Medicine, 2024, Vol 148, Issue 3, pe57
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/arpa.2022-0342-OA