Multiple Myeloma
This patient was a 51 year old woman with a known history of multiple myeloma, first diagnosed one year ago at an outside hospital. She had received several chemotherapy regimens but had residual multifocal vertebral compression fractures and lytic lesions. She was admitted to the emergency room ofCUMC 2 days before death with weakness, worsening fatigue and non-productive course. During her hospital stay she had evidence of biventricular failure, a small pericardial effusion and required maximum pressors for hypotension. She developed a cardiopulmonary arrest on the second hospital day and could not be resuscitated.
Questions
- For a woman aged 51, what are the appropriate proportions of fat and hematopoietic elements?
- What neoplasm is present in this section, and how do you recognize it?
- Is there any residual non-neoplastic bone marrow?
- What changes have developed in the vertebral bone itself?
- Since the patient's terminal admission was very heart-focussed, what disorder might you surmise is present, in light of the background history?