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Features such as renal dysfunction, a significant paraprotein, osteolytic lesions, hypercalcemia, and diffuse bone marrow involvement favor a diagnosis of plasmablastic plasma cell myeloma.
Plasmablastic Lymphoma: A Review of Clinicopathologic Features and Differential Diagnosis
A decreased anion gap (1-3 mEq/L) is consistent with elevated protein as seen in some malignancies, especially with a monoclonal paraprotein (multiple myeloma).
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Serologic data regarding monoclonal paraprotein for this cohort was available in 40 LPL cases (89%).
Significance of MYD88 L265P Mutation Status in the Subclassification of Low-Grade B-Cell Lymphoma/Leukemia
Paraprotein interference in automated chemistry analyzers.
A lipemic sample?
Lymphoplasmacytic lymphoma is a mature B-cell lymphoma with plasmacytoid appearance and differentiation and is mostly associated with paraprotein of immunoglobulin M type.
New Immunohistochemistry for B-Cell Lymphoma and Hodgkin Lymphoma
Aside from the standard laboratory testing, identification of monoclonal Ig (paraprotein) by serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE) are the current gold standards supported by the International Myeloma Working Group (IMWG) for diagnosis and monitoring therapy (2).
Heavy/light chain assay for monitoring IgA multiple myeloma: digging out the IgA from the [beta] region
(49) However, marginal zone lymphomas and other B-cell lymphoproliferative disorders may be associated with an IgM paraprotein, so this finding alone is not fully discriminatory.
Diagnosis of Splenic B-Cell Lymphomas in the Bone Marrow: A Review of Histopathologic, Immunophenotypic, and Genetic Findings
A Monoclonal gammopathy of undetermined significance (MGUS) is the term used to denote the presence of a monoclonal protein (M-protein, myeloma protein, or paraprotein) in persons without evidence of plasma-cell myeloma, Waldenstrom macroglobulinemia, primary amyloidosis, or related disorders.
Minimal monoclonal gammopathy
Artifactual hyperbilirubinemia due to paraprotein interference.
Monoclonal and Polyclonal Immunoglobulin Interference in a Conjugated Bilirubin Assay
(76) Flow cytometry is applicable to virtually all patients, and it is more sensitive than paraprotein or light-chain assessment.
Five Important Advances in Hematopathology
Multiple myeloma is a hematologic malignancy characterized by proliferation of a neoplastic plasma cell population that usually leads to abundant production of a monoclonal immunoglobulin, also called paraprotein or M-protein, as well as decreased concentrations of normal polyclonal immunoglobulins.
Unexpected test results in a patient with multiple myeloma
Nevertheless, we suggest the following: perhaps, the amount of paraprotein in the serum or urine was pathologic, but less than the limits of detection.
Progressive renal light chain amyloidosis with the absence of detectable free monoclonal light chains after an autologous hematopoietic stem cell transplant for amyloid light chain amyloidosis

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