Figure 1

Quick Quiz

Which of the following features can help differentiate this condition from multiple myeloma?

A 70-year-old patient presents with a four-month history of weakness, loss of appetite, and weight loss. The patient's chart indicates a 15-pound weight loss and a family history of diffuse large B-cell lymphoma. Medical history includes hypertension and coronary artery disease.

Examination reveals hepatosplenomegaly, purpura on the bilateral upper and lower extremities, and sensorimotor neuropathy of the distal extremities. Laboratory findings show a decreased hemoglobin, decreased platelet count, and increased ESR. A serum protein electrophoresis test later reveals a monoclonal IgM protein, which appears as a sharp spike.

Which of the following features, when present, can help differentiate this condition from multiple myeloma?

Image credit: @jmsmith