I have seen this once, just once. Two separate but newly diagnosed hematologic malignancies that require treatment simultaneously are rare. More common is a passenger MBL in a myeloma older than 70 y.o., MGUS in the setting of another lymphoid malignancy is not unheard of, and a T-cell gene rearrang...

This is a tough case for sure and something I've only seen in our VA population - still very rare. "Myeloma kidney" can mean any number of things, so I think a second-opinion pathological review of all slides - kidney, lymph node, BMBx, etc. - is imperative to make sure the right diagnoses are ...