A 48-year-old man with a history of diabetes was found to have an elevated serum immunoglobulin G (IgG) level (8.6 g/dL) during a routine blood workup. Further laboratory study and bone marrow biopsy confirmed IgG-κ type plasma cell myeloma. The patient underwent therapy with bortezomib, carfilzomib, and dexamethasone. One year later, he was referred to our hospital for evaluation of stem cell transplant.
On smears, cells are medium- to large-sized, with deeply basophilic cytoplasm, occasional cytoplasmic vacuoles, vague perinuclear hof, and folded or lobulated nuclei. A monocyte with gray to light-blue cytoplasm was included for comparison (image).
Neoplastic plasma cells mimic mature neutrophils in plasma cell myeloma