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Pathology · single question

A patient is found to have multiple myeloma. How is this condition most commonly diagnosed based on laboratory findings?

  1. Bone marrow biopsy showing plasma cell infiltration
  2. Elevated serum calcium alone
  3. Elevated serum protein electrophoresis alone
  4. Bence Jones proteins found in urine
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Correct answer: D. Bence Jones proteins found in urine

  • A. Incorrect. While bone marrow biopsy confirming >10% clonal plasma cells is the gold standard, the recall specifically identifies Bence Jones proteins as the diagnostic finding.
  • B. Incorrect. Hypercalcemia is a COMPLICATION of multiple myeloma (from bone destruction), not the primary diagnostic criterion.
  • C. Incorrect. Serum protein electrophoresis showing an M-spike is also diagnostic, but Bence Jones proteins (specifically in urine) is the recalled answer.
  • D. CORRECT. Bence Jones proteins (free immunoglobulin light chains — kappa or lambda) are found in the urine of multiple myeloma patients. Their detection on urine protein electrophoresis is a classic and key diagnostic finding in the work-up of multiple myeloma.

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