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Title: Digital image analysis of mean AgNOR area objectively discriminates between reactive plasmacytosis and multiple myeloma in cytologic smears from bone marrow aspirates. Author: Gunia S, Mai PA, Koch S. Journal: Pathobiology; 2008; 75(5):306-11. PubMed ID: 18931533. Abstract: OBJECTIVE: To differentiate between reactive plasmacytosis (RP) and multiple myeloma (MM) in bone marrow aspirates by assessment of silver-stainable nucleolar organizer regions (AgNORs). METHODS: Archival cytologic smears (n = 69) from bone marrow aspirates were retrospectively investigated. Twenty cases had RP and 49 cases MM (24 low-grade, 22 intermediate-grade and 3 high-grade MM). Diagnoses were confirmed by evaluation of the corresponding bone marrow trephine biopsies. Cytologic smears were subjected to AgNOR staining using a standardized silver-staining protocol and assessed by two independent clinical histopathologists using digital image analysis. AgNOR count and area were analyzed in 100 plasma cell nuclei per sample. RESULTS: The mean AgNOR area was found to be significantly (p < 0.001) higher in low-grade MM (mean: 23.4 microm(2); range: 19.2-26.7 microm(2)) than in RP cases (mean: 6.2 microm(2); range: 3.8-8.4 microm(2)). In contrast, mean AgNOR count failed to disclose significant differences between low-grade MM (mean: 5.36; range: 1-7) and RP (mean: 3.68; range: 1-6). CONCLUSION: Digital image analysis of the mean AgNOR area might be used as a diagnostically useful adjunct to aid objectively in the challenging differentiation between RP and MM in bone marrow aspirates.[Abstract] [Full Text] [Related] [New Search]