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Plasma Cell Disorders

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Multiple Myeloma

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Diagnostic features include monoclonal plasma cells in bone marrow, presence of serum and/or urinary monoclonal protein, and end-organ damage (CRAB criteria: hyperCalcemia, Renal failure, Anemia, Bone lesions). Treatment typically involves proteasome inhibitors, immunomodulatory drugs, and autologous stem cell transplantation.

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Monoclonal Gammopathy of Undetermined Significance (MGUS)

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Diagnostic features include the presence of serum monoclonal protein <3g/dL, clonal plasma cells in the bone marrow <10%, and no associated end-organ damage. Treatment is usually observation and monitoring due to its low risk of progression to myeloma.

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Light Chain Deposition Disease (LCDD)

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Diagnostic features include the deposition of monoclonal light chains in tissues, typically renal, which can be identified by biopsy and immunofluorescence. Treatment generally focuses on controlling the plasma cell disorder with chemotherapy and managing renal complications.

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Solitary Plasmacytoma

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Diagnostic features include a single mass of clonal plasma cells either in bone or soft tissue with no evidence of systemic disease, absence of CRAB features. Treatment typically involves targeted radiation therapy and possible surgery.

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Waldenström's Macroglobulinemia

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Diagnostic features include IgM monoclonal gammopathy, bone marrow infiltration with lymphoplasmacytic cells, and associated symptoms like hyperviscosity. Treatment often involves monoclonal antibodies (e.g., rituximab), chemotherapy, and plasmapheresis for hyperviscosity syndrome.

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AL Amyloidosis (Primary Amyloidosis)

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Diagnostic features include amyloid deposits in tissues confirmed with Congo red staining displaying apple-green birefringence under polarized light, and monoclonal light chains in serum or urine. Treatment can involve chemotherapy, autologous stem cell transplantation, and supportive therapy for involved organs.

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