The diagnosis of POEMS syndrome can be elusive, with overlap between other medical conditions. It is characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes, though not all findings are present in all patients. This image set demonstrates these findings in a 39-year old male with a diagnosis fo POEMS syndrome whose pre-treatment bone marrow biopsy showed the above features.

Unique features of bone marrow histopathology in POEMS have previously been described that may carry diagnostic utility. These include:

1. Plasma cell rimming around lymphoid aggregates
2. Light chain restricted plasma cells, commonly lambda.
3. Megakaryocyte hyperplasia and atypia
4. Osterosclerosis