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Differential diagnosis

Authoring team

This includes:

  • benign monoclonal gammopathy:
    • there is no skeletal disease, no hypogammaglobinaemia, and no Bence Jones protein
    • observe if in doubt since there is no advantage to early treatment of asymptomatic multiple myeloma
  • smouldering (asymptomatic) multiple myeloma
  • symptomatic multiple myeloma
  • plasmacytoma (1)
  • reactive polyclonal hypergammaglobulinaemia - distinguished on basis of single or polyclonal spike
  • other malignant lymphoproliferative diseases:
    • Waldenstrom's macroglobulinaemia
    • lymphomas
    • primary amyloidosis
    • osteosclerotic myeloma

Reference:

  1. Sive, J., Cuthill, K., Hunter, H., Kazmi, M., Pratt, G., Smith, D. and (2021), Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Br. J. Haematol., 193: 245-268.

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