Hematologic investigations: Morphologic and phenotypic features of myeloma marrow diagnosis

This chapter emphasizes both the morphologic and phenotypic features of the bone marrow in plasma cell myeloma. It details the morphologic features of both trephine biopsies and marrow aspirations. It emphasizes the salient phenotypic features of marrow myeloma cells, in contrast with normal plasma cells. The myeloma cell phenotype is discussed from the perspective of both tissue section immunohistochemistry (IHC) and flow cytometry (FACS analysis). The specific criteria for myeloma diagnosis are discussed and illustrated in Figs 8.1-8.21. Finally, the differential diagnosis of myeloma is discussed emphasizing the key morphologic and phenotypic diagnostic criteria of each entity.