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The above painting is of a bone marrow biopsy showing replacement of the hematopoietic elements with plasma cells, including atypical plasma cells (Mott cells and plasma cells with Dutcher bodies shown). This can be seen in plasma cell myeloma. Multiple myeloma can be diagnosed with the presence of a plasma cell myeloma (>10% clonal bone marrow plasma cells), and one or more myeloma-defining events. These include hypercalcemia, renal insufficiency, anemia, or lytic lesions within bones. On a kidney biopsy, light chain cast nephropathy is a myeloma defining event and is a paraprotein-associated renal disease. Other renal manifestations that can occur...