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Year : 2021  |  Volume : 7  |  Issue : 3  |  Page : 265-268

Plasma-Cell Myeloma with Double M-Bands on Serum Protein Electrophoresis: A Diagnostic Conundrum?

Department of Pathology, ABVIMS and Dr RML Hospital, Delhi, India

Correspondence Address:
Vijay Kumar
Department of Pathology, ABVIMS and Dr RML Hospital, New Delhi 110001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mamcjms.mamcjms_54_21

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Plasma-cell myeloma (PCM) is a monoclonal gammopathy (MGM) characterized by proliferation of abnormal clone of plasma cells infiltrating the bone marrow with consequent end-organ damage. The clonal plasma cells secrete a single clone of immunoglobulins (Igs) leading to presence of M-protein in the serum and/or urine. The M-protein is appreciated as a discrete band on serum protein electrophoresis (SPE) in the gamma globulin region, also called the M-band. Biclonal gammopathy (BGM) occurs due to neoplastic transformation of a plasma-cell clone undergoing Ig class switching or due to an independent neoplastic transformation event yielding proliferation of unrelated plasma-cell clones, therefore resulting in two distinct M-bands on SPE. It is, however, vital to distinguish a true BGM from an apparent one (MGM presenting with two distinct bands on SPE) so as to make an accurate diagnosis. Hereby, we report a case of a 61-year-old man, diagnosed with PCM and presenting with two discrete bands on SPE (simulating a BGM) which turned out to be monoclonal in nature.

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