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case_images: The examination of CT scan.
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case_images: Following computed tomography (CT) examination (Figure 1), the patient was diagnosed with acutely exacerbated chronic obstructive pulmonary disease and a medium-risk right pulmonary embolism.
case_images: Serum immunofixation electrophoresis.
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case_images: A, IgM, and light chain kappa and lambda values were 12.7, 1.3, 5.6, 8.54, and 2.47 g/L, respectively. Agarose gel electrophoresis was used to perform serum immunofixation electrophoresis (IFE) (Figure 2), which indicated the presence of a monoclonal IgM kappa component and a monoclonal IgM lambda component in the gamma region.
case_images: Urine immunofixation electrophoresis.
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case_images: The urine IFE (Figure 3) exhibited only a monoclonal lambda component.
case_images: Bone marrow smears.
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case_images: Examination of the bone marrow smears (Figure 4) showed predominantly abnormal lymphocytes, alongside morphologically normal plasma cells, accounting for 4.5% of the nucleated hematopoietic cells.
case_images: Flow cytometry analysis.
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case_images: Flow cytometry analysis (Figure 5) indicated that these cells were positive for cKappa, CD38, CD138, CD56, and CD81, but negative for CD117, CD19, CD27, and cLambda.