case_images: PMC8363435_01
case_images: Representative micrograph of the bone marrow biopsy (a, b); original magnification x20 haematoxylin eosin (H&E) stain shows a diffuse infiltration by plasma cells with suppressed trilineage haematopoiesis. These plasma cells are positive for CD138 and negative for CD56.
case_images: CRIHEM2021-4843818.001.jpg
case_images: PMC8363435_01_CRIHEM2021-4843818.001.jpg
case_images: fig1
case_images: On reassessment, there was clearance of peripheral blood plasmacytosis on the peripheral smear; however, bone marrow biopsy had persistent bone marrow plasmacytosis of 90% with immunohistochemistry stains being positive for CD138, CD 20, MUM 1, and BCL 2 with negative CD56, as shown in Figure 1.
case_images: PMC8363435_02
case_images: Serum protein electrophoresis showing an M protein of 4.2 g/l.
case_images: CRIHEM2021-4843818.002.jpg
case_images: PMC8363435_02_CRIHEM2021-4843818.002.jpg
case_images: fig2
case_images: Serum protein electrophoresis showed an M band of 4.2 g/l, as shown in Figure 2, with elevated lambda free light chains of 461 mg/l.
case_images: PMC8363435_03