Pathology – MCQ 41 – A 70 year old male with a pathologic fracture of femur

A 70 year old male has a pathologic fracture of femur. The lesion appears as lytic on X-rays film with a circumscribed punched out appearance. The curetting from fracture site is most likely to show which of the following?
a) Diminished and thinned trabecular bone fragments secondary to osteopenia
b) Sheets of atypical plasma cells
c) Metastatic prostatic adenocarcinoma
d) Malignant cells forming osteoid bone

Correct answer : b) Sheets of atypical plasma cells

An elderly patient presenting with lytic, circumscribed punched out lesions on X-ray suggests diagnosis of multiple myeloma. Gross pathology shows gelatinous soft red tumour masses. Histopathology shows plasma cells which infiltrate the marrow diffusely or form sheet like masses and replace the normal marrow elements.