All of the following are true about multiple myeloma except –
**Core Concept**
Multiple myeloma is a plasma cell malignancy characterized by the proliferation of malignant plasma cells in the bone marrow, leading to various clinical manifestations. The disease is often associated with bone destruction, renal impairment, and anemia.
**Why the Correct Answer is Right**
The correct answer involves a chromosomal translocation, which is not typically associated with multiple myeloma. The most common translocations in multiple myeloma involve the immunoglobulin heavy chain (IgH) locus on chromosome 14q32, often with various partner genes such as CCND1 (cyclin D1), MMSET (multiple myeloma SET domain), or FGFR3. The mentioned translocation (18-14) is not a characteristic genetic abnormality of multiple myeloma.
**Why Each Wrong Option is Incorrect**
**Option A:** Osteolytic bone disease is indeed a hallmark of multiple myeloma, resulting from the uncontrolled proliferation of malignant plasma cells and the subsequent release of osteoclast-activating factors.
**Option C:** Light chain proliferation is a key feature of multiple myeloma, often leading to the production of excess light chain proteins, which can accumulate in the kidneys and cause renal impairment.
**Option D:** Bence-Jones proteins are free light chains that are often found in the urine of patients with multiple myeloma, serving as a diagnostic marker for the disease.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that multiple myeloma is characterized by a complex interplay between various genetic and molecular abnormalities. The disease often presents with a combination of clinical features, including bone pain, anemia, renal impairment, and hypercalcemia, which can be used to guide diagnosis and treatment decisions.
**β Correct Answer: B. (18-14) translocation**