TCM Diagnosis based on syndrome differentiation:
1.  Stagnant heat invading the meridians
Manifestation: chest and rib pain, dark yellow complexion, thirst, fever, dark purple tongue, yellow greasy coating, thin pulse.
 
2. Deficiency of both qi and yin
Manifestation: Pale complexion, dizziness, fatigue, night sweat, spontaneous perspiration, hot flash, soreness of waist, swelling, red tongue.

3. Accumulation of Heat Toxins
Manifestation: hyperpyrexia, dry mouth, shortness of breath, skeleton pain, thin pulse.


Diagnosis in western medicine
1) Blood and urine tests
An abnormal protein produced by the plasma cells, called a monoclonal (M) protein, can be found in the blood or urine of almost all patients with MM, which helps establish the diagnosis. M proteins serve no useful function, and may be responsible for increases in the thickness of the blood, kidney damage, or bleeding problems. In some patients, "free light chains" (FLCs), which represent a small portion of the paraprotein, are secreted either in addition to the M protein or by itself. These can be measured by an assay called the free light chain assay. The assay measures the two types of free light chains, kappa and lambda, which are made by plasma cells, and provides a ratio of the two.

2) Bone marrow aspiration and biopsy
These two procedures are similar and often done at the same time to examine the bone marrow. Bone marrow has both a solid and a liquid part. A bone marrow aspiration removes a sample of the fluid with a needle. A bone marrow biopsy is the removal of a small amount of solid tissue using a needle, and it is important to making a diagnosis of myeloma.

3) Positron emission tomography (PET) scan
A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

4) X-ray
An x-ray is a way to create a picture of the structures inside of your body using a small amount of radiation. X-rays are typically the first step in evaluating bones when myeloma is suspected or diagnosed.

5) Magnetic resonance imaging (MRI)
An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. An MRI can show replacement of normal bone marrow by myeloma cells or plasmacytoma (a plasma cell tumor growing in bone or soft tissue), especially in the skull, spine, and pelvis. The detailed images may also show compression fractures of the spine or a tumor pressing on nerve roots. MRI can also be used to measure the tumor’s size.

6) CT scan
A CT scan creates a detailed, cross-sectional view that shows any abnormalities or tumors in soft tissues. A computer then combines these images into a three-dimensional picture of the inside of the body. It is important to note that, intravenous contrast dye often used for CT scans for other types of cancer is specifically avoided in patients with multiple myeloma. Please tell the radiologist or the radiology technician about your diagnosis before receiving dye injection into your vein.