Auer rod-like inclusions in κ light chain myeloma

A 56-year-old woman with a history of dyslipidemia and hepatic steatosis presented with weight loss and progressive proteinuria. The presenting blood count was normal: white blood cells, 10.9 × 10⁹/L; hemoglobin, 15.5 g/dL; platelet count, 236 × 10⁹/L. No significant rouleaux formations were present on the peripheral blood smear. Calcium (9.28 mg/dL), blood urea nitrogen/creatinine (15/0.78 mg/dL), and protein/albumin (6.9/4.2 g/dL) were normal. The squelettal survey showed no lytic bone lesions. Serum protein electrophoresis and immunofixation electrophoresis showed no monoclonal component. Serum-free light chain assay revealed high levels of κ light chains (890 mg/L) and normal levels of λ light chains (9.8); κ-λ ratio was 90.8. Urine protein electrophoresis showed free κ-type Bence-Jones proteinuria (1.64 g/L). A bone marrow aspiration revealed a normal blast count (3%) and no dysplasia. Plasma cells constituted 20% of nucleated cells.

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Auer rod-like inclusions in κ light chain myeloma

Source: Blood
Image credits: ASH image bank

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