Appendiceal neuroma or neurogenous hyperplasia of the appendix is an uncommon entity. We report an incidental finding of an appendiceal neuroma in a 35 year male patient who underwent appendectomy. On microscopy showed thickened appendicular wall with well circumscribed submucosal nodules of proliferating spindle cells in myxoid areas, eosinophilic cell infiltration and obliterative appendicitis. It was reported as appendiceal neuroma. We are presenting this case for its uncommon entity, clinical and histopathological finding.

BACKGROUNDMultiple myeloma is also called as plasma cell myeloma or myelomatosis. It is a malignant clonal proliferation of neoplastic plasma cells within the bone marrow. Its incidence increases with age. Multiple Myeloma accounts for 1% of all human cancers and 10% of all haematological malignancies. We wanted to study clinical presentation of multiple myeloma and haematological parameters along with bone marrow aspiration with biopsy interpretations. METHODSThis is descriptive, analytical study. The total 212 bone marrow aspirations were done during study period at Department of Pathology and evaluated for MM. The Study period was 3 years from January 2016 to December 2018 at our tertiary care hospital. Detailed clinical data including all biochemical investigations, routine and specific haematological investigations were done. The imaging findings, serum electrophoresis, urine analysis etc were considered. The bone marrow aspiration and biopsy study were done. RESULTSIn data analysis for 3 years, total 12 cases of multiple myeloma were diagnosed. The male: female ratio was 2:1. The age range was 55-79 years, with mean age 67 years. The common clinical presentation was bony pain (66%), followed by renal failure (25%), neurological symptom (pain) (41.7%), easy fatigability (66.7%), infection (6%), etc. On investigation, it was observed that anaemia (75%), lymphocytosis (33.3%), elevated ESR (66.7%), increased serum creatinine (83.3%), increased serum calcium (91.7%), BJ proteinuria (50%) were seen in various cases. On serum electrophoresis, M-band was noted in all patients. Bone marrow plasmacytosis was noted in 100% cases with mean count was 41%. On radio imaging 75% showed bony lytic lesions. CONCLUSIONSElderly patients with unexplained anaemia, bony pain and renal manifestations should be investigated for multiple myeloma. Bone marrow aspiration, electrophoresis, and related investigations. It plays an important role in diagnosis and management of multiple myeloma cases.

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