A 54-year-old male presents with 1 month of low back pain, f…
A 54-year-old male presents with 1 month of low back pain, feeling tired easily, and constipation. He denies any fever, night sweats, cough, trauma, or tingling/weakness in the limbs. On examination, the vital signs are normal. Physical examination reveals tenderness along the L4/L5 area. Abdominal and chest exams are normal. X-ray of the lumbar spine shows lytic bone lesions. Laboratory results are a hemoglobin level of 9 g/dL, a serum calcium level of 12.5 mg/dL, and increased urea nitrogen and creatinine. Urine electrophoresis reveals Bence Jones protein. Which of the following is most likely present in the peripheral blood smear?