Splenic aspirations in multiple myeloma.

T HE TECHNIC of spleisic aspirations has beets used ins over onse hunidred amid fifty cases at Kinsgs Coumst-y Hospital durinsg the past five years’ as ant aid to the diagusosis amsd study of hematologic disorders. Ins 1951 the enslarged spleems of ant unsdiagmsosed patietst was aspirated ausd fouusd to have 27 per ceust plasma-myeloma cells. The diagntosis of multiple myeloma was subsequemstly substaustiat-ed. The high iuscidensce of extraosseous lesions ins this disease reported in the hiterature24 has led some5 #{176} to speculate as to whether multiple myeloma is a gemseralized disease of the hematopoietic system analogous to leukemia. Oms the other hatid, some” have conssidered multiple myeloma to he a mseoplastic disease of the skeletal system with occasionsal metastatic spread. It seemed to us that a study of splemsic aspiratiouss ins several comssecutive patiensts with multiple myeloma might throw some hight ott this constroversial subject. 1)iffuse instiltrations of the spleens with tumor (‘ells ius other types of iseoplasms is much less commons, arid when itoccurs, is usually ins a localized form. Its order to itse conssecutive patients, it was, of course, nsecessary to aspirate nionspalpable as well as palpable spleemis. There were three advanst-ages to this study: 1 . Patiensts could he studied at any stage of their disease. 2. Ranidom samples of the spleens could be obtainsed because only a minsute fractions of the whole organs is studied ins a msonsselective mamimser. 3. Slide smears of splensic aspirations are morphologically similar to marrow amsd blood smears so that stamsdard hematologic criteria could be used for identification. Amstemortem material lacks the autolytic artefacts iushereust ins autopsy material. Also, because of shrinskage itt fixed tissue, the morphologic criteria for distinsguishinsg a normal plasma cell from the myeloma cell may be ohscinred. Ins fact, Churg and Gordon2 ins their paiusstakinsg histologic study fouisd it necessary to use such addit-ionsal criteria for studies dealimsg with stilbamadinte granules and Russell bodies.