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Actions	Vertebrae and other bones showing multiple myelomatosis Remove from selection Add to selection Object numberGC.10466 TitleVertebrae and other bones showing multiple myelomatosis DescriptionVertebrae and other bones showing multiple myelomatosis, a type of bone marrow cancer From a male aged 64 who for more than a year had severe pain in the lumbar region. He had been in failing health during this period and recently had been subject to attacks of unconsciousness. When seen he was cachectic end pain compelled him to lie still in bed. There was typical Addisonian pigmentation of the hands, upper parts of thighs and abdominal wall. Radiographs revealed neoplastic changes in the lumbar vertebra and Paget’s disease of the right tibia. Sternal puncture smears showed myelomatosis. The clinical symptoms suggested a cerebral metastasis but there was no papilloedema and the C.S.F. and encephalogram were normal. Hb. Was 55%.; no abnormal cells were present in the peripheral blood; blood albumen 0.94; globulin 8.10. Radiotherapy was given to the spine and a course of urethane administered. The patient rapidly became weaker and died in hyperpyrexia. The post-mortem showed multiple myelomatosis of diffuse plasma cell type, involving chiefly the sternum, ribs and vertebrae. The right tibia was deformed due to Paget’s disease (vide 1.SX.(3). There were recent and old haemorrhages in the brain, extensive bronchopneumonia in both lungs and cloudy swelling of liver, kidneys and myocardium. The lower six thoracic vertebrae in section show thinning of the bony cortex, absorption of the trabeculae and replacement by dark red semi fluid marrow. This has resulted in weakening of the bone so that in most of the vertebrae the nucleus pulposus tends to bulge slightly into the vertebral body. A slight degree of collapse of the bodies has taken place in the 7th and 9th thoracic vertebrae. There is no evidence of extradural myxomatous infiltration. The section of the upper end of the right femur shows in the neck some dark marrow which extends downwards to the level of the lesser trochanter. A few foci of dark marrow are seen still lower, but elsewhere the marrow is fatty and oedematous. The sternum shows a thinned bony cortex and. almost complete replacement of the spongy bone by very dark semi fluid marrow. In the calvarium there is a little dark marrow in the diploe but nothing to suggest Paget’s disease. Microsections of the sternal and vertebral marrow show the normal blood forming elements mostly replaced by large myelomatous plasma cells of predominantly intermediate and early types. The cells contain a large eccentric nucleus in which the nucleolus stands out prominently. The cytoplasm is abundant and darkly basophilic and in occasional cells there is a perinuclear halo and in others well marked vacuolation of the cytoplasms. Mitotic figures are not numerous. Object nameSKULL, femur, vertebrae & sternum Object categoryAnatomical, specimen Dimensions Height: 21.8 cm Width: 27.3 cm Depth: 8.0 cm

Object numberGC.10466

TitleVertebrae and other bones showing multiple myelomatosis

DescriptionVertebrae and other bones showing multiple myelomatosis, a type of bone marrow cancer From a male aged 64 who for more than a year had severe pain in the lumbar region. He had been in failing health during this period and recently had been subject to attacks of unconsciousness. When seen he was cachectic end pain compelled him to lie still in bed. There was typical Addisonian pigmentation of the hands, upper parts of thighs and abdominal wall. Radiographs revealed neoplastic changes in the lumbar vertebra and Paget’s disease of the right tibia. Sternal puncture smears showed myelomatosis. The clinical symptoms suggested a cerebral metastasis but there was no papilloedema and the C.S.F. and encephalogram were normal. Hb. Was 55%.; no abnormal cells were present in the peripheral blood; blood albumen 0.94; globulin 8.10. Radiotherapy was given to the spine and a course of urethane administered. The patient rapidly became weaker and died in hyperpyrexia. The post-mortem showed multiple myelomatosis of diffuse plasma cell type, involving chiefly the sternum, ribs and vertebrae. The right tibia was deformed due to Paget’s disease (vide 1.SX.(3). There were recent and old haemorrhages in the brain, extensive bronchopneumonia in both lungs and cloudy swelling of liver, kidneys and myocardium. The lower six thoracic vertebrae in section show thinning of the bony cortex, absorption of the trabeculae and replacement by dark red semi fluid marrow. This has resulted in weakening of the bone so that in most of the vertebrae the nucleus pulposus tends to bulge slightly into the vertebral body. A slight degree of collapse of the bodies has taken place in the 7th and 9th thoracic vertebrae. There is no evidence of extradural myxomatous infiltration. The section of the upper end of the right femur shows in the neck some dark marrow which extends downwards to the level of the lesser trochanter. A few foci of dark marrow are seen still lower, but elsewhere the marrow is fatty and oedematous. The sternum shows a thinned bony cortex and. almost complete replacement of the spongy bone by very dark semi fluid marrow. In the calvarium there is a little dark marrow in the diploe but nothing to suggest Paget’s disease. Microsections of the sternal and vertebral marrow show the normal blood forming elements mostly replaced by large myelomatous plasma cells of predominantly intermediate and early types. The cells contain a large eccentric nucleus in which the nucleolus stands out prominently. The cytoplasm is abundant and darkly basophilic and in occasional cells there is a perinuclear halo and in others well marked vacuolation of the cytoplasms. Mitotic figures are not numerous.

Object nameSKULL, femur, vertebrae & sternum

Object categoryAnatomical, specimen

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