1. Plasma cell neoplasm Plasma cell Ig M component, para protein Monoclonal gammopathy

2. Multiple Myeloma Bone marrow based Median age 70 Multifocal, bone, tumor masses Serum paraprotein, Urine Bence-Jones protein Osteolytic lesions, bone pain, hyper calcemia, anemia Renal failure

3. Morphology –Increased plasma cells ( mature, immature and anaplastic) –Mass of plasma cells –Ig inclusions Immuno: CD20 neg, cytoplasmic Ig IgG>IgA

5. Lambda

8. Plasmacytoma Localized osseous or extra osseous plasma cell tumor

10. kappa

11. Monoclonal Gammopathy of Undetermined Significance MGUS Asymptomatic M protein (less than myeloma) BM Plasmacytosis <10% 25% progress to Multiple Myeloma

12. Lymphoplasmacytic lymphoma B cell lymphoma Leukemic with bone marrow involvement Low grade Paraprotein IgM Waldensrom macroglobulinemia