Submitted by Ahmad Alkhasawneh

Back pain from a compression fracture

58-year-old man with acute on chronic back pain and found to have compression fracture L2. Lab findings are shown, and bone marrow biopsy was performed. Representative cells from marrow aspirate smears and representative bone marrow are provided. Work up (including immunohistochemistry on tissue, flow cytometry, SPEP, free light chains, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".