Author contributions
Huirui Wang led the design of the dissertation. Jie Li and Jiashan Zhao
are mainly responsible for case collection and article writing. Songyun
Wang, Rundong Wu, Shuyi Duan participated in the proofreading of the
article.
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Figure legend :
Figure1 (A) Serum Protein Electrophoresis. (B) Serum Immunofixation
Electrophoresi
Figure2(A)TP53 gene mutation detection.(B,C) Bone marrow tissue
pathology. The hematopoietic tissue exhibits markedly active
proliferation, constituting over 90% of the total volume, accompanied
by increased adipose tissue; Granulocytic series proliferation is
observed, with scattered immature precursors, predominantly cells at the
intermediate and earlier stages, showing no obvious morphological
abnormalities;Erythroid series proliferation is evident, primarily
composed of intermediate and late-stage immature red cells, with no
evident morphological abnormalities;Megakaryocytic cell proliferation
is noted (0-5 per high-power field), scattered in distribution, with
sizes and morphology showing no clear abnormalities;Suspected plasma
cells are dispersed or focally increased, featuring moderate-sized cell
bodies, round or oval nuclei, and abundant cytoplasm;Reduced bone
marrow proliferation, scattered distribution of plasma cells, and mature
red blood cells arranged in cord-like patterns.(D)Hematologic tumor
immunophenotyping test. In areas where CD45 is negative and there is a
distribution of abnormal cell clusters with larger size in both forward
scatter (FSC) and side scatter (SSC) compared to lymphocytes, these
clusters constitute approximately 1.5% of nucleated cells. These cells
exhibit positive expression for CD28, CD38, CD117, CD138, and cKappa,
suggesting the presence of abnormal plasma cells.