Multiple myeloma of the central nervous system: a clinicopathological review

Multiple myeloma [MM] is a systemic malignancy of pathologic plasma cells that is treatable with chemotherapeutic agents and irradiation, but rarely curable. The spectrum of neurological complications of MM is diverse; however, involvement of MM in the cerebrospinal fluid and leptomeningeal infiltration is considered rare. There have been many reviews of central nervous system complications in MM but there are none on intracranial and leptomeningeal infiltration of MM. We review this here along with our clinicopathological experience and a summary of our present knowledge of this condition

Predictors for early diagnosis of CNS infiltration in acute lymphoblastic leukemia

The study was held to define the factors helping in prediction of CNS infiltration by leukemia [ALL], type and rate of relapse. Also studing clinical and laboratory diagnosis especially CSF analysis at the primary diagnosis. The study was done in pediatric oncology unit of Zagazig University Hospital on 24 cases of newly diagnosed ALL ranging from 1-14 years. Males were 16 cases and females were 8 cases with male to female ratio of 2: 1. L[1] represented 75% of cases, Patients were subjected to different tests e.g CBC with differential count, hemoglobin level and B[2] microglobulin, bone marrow aspiration, morphological and chemical tests. CNS relapses were 20.9% of cases, hematological relapses were 12.9% and testicular relapses were 4.2%. Serum B[2] microgIobulin, CSF B[2] microglobulin and CSF LDH are useful indicators for cytological diagnosis of CNS infiltration at time of presentation. Cases with elevated B[2] M and/or LDH levels at presentation should be subjected to intensive CNS prophylaxis and CSF monitoring and follow up for better diagnosis and prognosis

Beta 2 microglobulina en algunas neoplasias hematológicas / Beta 2 microglobulin in hematologic neoplasias

Beta 2 microglobulin is alow molecular weight protein integrating the light chain HLA antigens Its serum concentration is increased in different neiplasias and in renal failure. Using solid phase Ria we determined the concentration of beta 2 microglobulin in plasma and spinal fluid of 57 healthy individuals and patients with hematologic neoplasia. Serum levels were 1.34 ñ 0.34 mg/l and spinal fluid levels were 1.3 ñ 0.7 mg/l in healthy subjects. Serum levels in 29 patients with myeloma was 7.51 mg/l, significantly highy in those with renal failure (12.35 mg/l) compared to those without (4.54). In 30 patients with non- Hodgkin lymphoma the mean serum levels were 2.90 mg/l, significantly greater in those with active disease (3.18) than in those with remission (1.5). No diference was founde according to the degree of malignancy. Patients with acute lymphatic leukemia had elevated values of beta 2 microglobulin while the disease eas active (3.37 mg/l), decreasing to normal levels after remission 91.79 mg/l). Spinal fluid levels of beta 2 microglobulin were elevated onfly in patients with central nervous system involvement. our results indicate that serunm levels of beta 2 microglobulin are helpful in patients with hematologic neoplasia in assessing the activity of the disease and tumor mass, especially in multiple myeloma