A 65-year-old man was admitted for investigation of syncope and blurred vision. On admission, his peripheral blood showed mild rouleaux formation. Serum protein electrophoresis demonstrated a monoclonal spike and immunofixation confirmeda monoclonal IgM-kappa pattern. Immunoglobulin quantitation revealed 3.2 g/dl of IgM with decreased IgG and IgA. His axillary lymph node was enlarged and a biopsy was done (Fig. 31.1). Subsequently, a bone marrow biopsy was performed (Figs. 31.2 and 31.3).


Marginal Zone Lymphoma Hematologic Neoplasm Lambda Light Chain Plasma Cell Myeloma Plasma Cell Differentiation 
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