Blood routine tests are the most fundamental and widely applied screening procedures in clinical diagnostics

capable of rapidly reflecting hematopoietic function and overall health status

providing crucial clues for early disease identification. This article reports a case of an elderly patient presenting primarily with fatigue and pathological fractures. The blood routine test revealed a characteristic "hanging top phenomenon" in the lymphocyte scatter zone

which

combined with instrument alerts and peripheral blood smear microscopy

provided significant evidence for early disease identification. Subsequent biochemical tests

immunofixation electrophoresis

and bone marrow examination confirmed the diagnosis of immunoglobulin G-κ type multiple myeloma. After establishing the diagnosis

the patient was treated with a bortezomib-based combination chemotherapy regimen. Post-treatment

the patient's anemia and fatigue symptoms improved

and the condition stabilized. This case highlights that attention to abnormal blood routine scatter plots and detailed analysis by laboratory personnel can significantly enhance the early diagnosis rate of multiple myeloma

offering strong support for timely clinical intervention and improved patient prognosis.