Rouleaux in a Peripheral Smear, Multiple Myeloma

Rouleaux in a Peripheral Smear, Multiple Myeloma
#00061458
Author: Heather Smith, MD, PhD; Girish Venkataraman, MD
Category: Lymphoma: Mature B-cell and Plasma cell Neoplasms > Plasma Cell Neoplasm > Plasma cell myeloma
Published Date: 05/29/2018

This is a peripheral smear from a patient with multiple myeloma, in which numerous rouleaux and a single circulating plasma cell (arrow) is seen. Rouleaux are linear aggregates of red blood cells that form in the presence of increased plasma proteins. This phenomenon differs from agglutination, in which red blood cells form grape like clusters due to the presence of antibodies bound to their surfaces.