Diseases associated with a monoclonal (or myeloma) protein (M protein) included in this presentation are:

1. Asymptomatic plasma cell neoplasia with minimal evidence of disease aside from the presence of an M protein (monoclonal gammopathy of undetermined significance [MGUS]).[1] (Usually IgG kappa or lambda, IgA kappa or lambda.)



2. Symptomatic plasma cell neoplasia. (Usually IgG kappa or gamma, IgA kappa or gamma.)
   1. Primarily affecting bones:
      1. Multiple myeloma (94%).
      2. Solitary plasmacytoma (3%).
   2. Extramedullary plasmacytoma (3%).

      These usually occur in the nasopharynx, tonsils, or paranasal sinuses.[2]




3. Macroglobulinemia.

   Patients often have lymphadenopathy and hepatosplenomegaly; less than 5% of patients have lytic bone lesions. (Usually IgM kappa or gamma.)

   1. Asymptomatic.
   2. Symptomatic.[3]

   This entity is called lymphoplasmacytic lymphoma or Waldenström macroglobulinemia. (Refer to the PDQ summary on Adult Non Hodgkin Lymphoma Treatment for more information.)

References

1. Kyle RA, Bladé J, Rajkumar SV: Monoclonal gammopathies of undetermined significance. In: Malpas JS, Bergsagel DE, Kyle RA, et al.: Myeloma: Biology and Management. 3rd ed. Philadelphia, Pa: WB Saunders Co, 2004, pp 315-52. 
   
   
2. Knowling MA, Harwood AR, Bergsagel DE: Comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone. J Clin Oncol 1 (4): 255-62, 1983.  [PUBMED Abstract]
   
   
3. Kyle RA, Garton JP: The spectrum of IgM monoclonal gammopathy in 430 cases. Mayo Clin Proc 62 (8): 719-31, 1987.  [PUBMED Abstract]
   
   

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