Heterogeneity of genomic evolution and mutational profiles in multiple myeloma.

Multiple myeloma is an incurable plasma cell malignancy with a complex and incompletely understood molecular pathogenesis. Here we use whole-exome sequencing, copy-number profiling and cytogenetics to analyse 84 myeloma samples. Most cases have a complex subclonal structure and show clusters of subclonal variants, including subclonal driver mutations.

Right atrial mass--a venous thrombosis in transit.

Right heart thrombi are unusual complications of pulmonary embolism that are associated with a high early mortality. We present a case and transoesophageal echocardiography of a 65-year-old man who presented with pulmonary embolism, following routine knee replacement and was found to have a type A right heart thrombus. Despite the increased risk associated with this presentation, treatment with heparin alone was successful.