Differential Diagnosis
Other plasma cell proliferative disorders may be considered which include the following:
- Plasma cell proliferative disorders that do not meet the criteria for multiple myeloma but may eventually progress into multiple myeloma
- Solitary (isolated)
plasmacytoma
- Diagnostic criteria should include all of the following: Biopsy-confirmed solitary bone or soft tissue lesion with evidence of clonal plasma cells, normal bone marrow without any evidence of clonal plasma cells, normal skeletal survey, and no abnormalities in CT and MRI except for a primary solitary lesion, no evidence of end-organ damage (CRAB criteria) attributable to any plasma cell proliferative disorder
- May progress into multiple myeloma (14-38% progression rate in 3 years)
- Extramedullary plasmacytoma
- Monoclonal gammopathy of clinical significance (MGCS): Includes monoclonal gammopathy or renal significance (MGRS), monoclonal gammopathy of neurological significance (MGNS), monoclonal immunoglobulin disease (MIDD), and Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, and Skin changes (POEMS) syndrome
- Waldenström macroglobulinemia
Light chain amyloidosis, plasma cell leukemia, heavy chain disease, and bone metastasis may also be considered as differential diagnoses.