Case Presentation: A 68 year old Ohioan male with history of chronic renal failure and prior evaluation for monoclonal gammopathy of undetermined significance (MGUS) presents with weakness and unintentional weight loss. Previous work up identified Bence Jones proteinuria, normal K/L ratio, serum immunofixation (IF) and serum protein electrophoresis (SPEP) with two IgG lambda bands and [...]