Serum Electrophoretic Pattern and Morphology of Myeloma Cells : An Attempt at Correlation

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.