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1 Veterans Administration Hospital and the Departments of Pathology and
Medicine, University of Minnesota Medical School.
The electrophoretic pattern of the serum proteins of 27 patients with multiple
myeloma have been compared to the morphologic characteristics of the abnormal cells in the smear of the bone marrow. The cases were classified into four
types of serum globulin abnormalities: Normal pattern or minimal protein
alteration, "beta" pattern, "M" pattern, and "gamma" pattern. The following
morphologic characteristics of the myeloma cells were evaluated: Diameter of
the nucleus, diameter of the cell, eccentricity of the nucleus, clumping of nuclear
chromatin, presence and number of nucleoli, mitoses, color of the cytoplasm,
multiplicity of nuclei, presence of detached masses of cytoplasm in the smear,
vacuoles in the cytoplasm, granularity of the cytoplasm, peripheral rim of
darkly stained cytoplasm, Russell bodies, Mott cells, presence of a "Hof" and
rouleaux formation of the red blood cells. The relative area of the cytoplasm, derived from the diameter of the myeloma
cell, was found to be the most valid among all morphologic characteristics in
predicting the type of serum protein pattern. Small size and a small amount of
cytoplasm of myeloma cells were related to the beta globulin pattern while
large size and abundant cytoplasm were related to the gamma and "M" globulin
patterns.
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