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Pathology · Hematopathology: multiple myeloma
Sample itemA patient has bone pain, lytic lesions, anemia, renal impairment, and high total protein. Which malignancy is most likely?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Multiple myeloma
Multiple myeloma is a clonal plasma-cell neoplasm causing CRAB features: hypercalcemia, renal impairment, anemia, and bone lesions. Monoclonal protein studies and marrow assessment establish diagnosis.
Option by option
A. Hodgkin lymphoma
Hodgkin lymphoma typically presents with lymphadenopathy and Reed-Sternberg cells.
B. Acute lymphoblastic leukemia
ALL presents with marrow failure and lymphoblasts, often in children.
C. Essential thrombocythemia
Essential thrombocythemia is a myeloproliferative disorder with elevated platelets.
D. Multiple myeloma (correct)
Correct. Lytic bone disease with anemia, renal dysfunction, and paraprotein suggests myeloma.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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