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For most\u2014but not all\u2014patients, the presence of a small monoclonal protein will have no clinical significance at the time of recognition or even over time. It is imperative, therefore, that a careful\u2014but sensible\u2014evaluation be performed both at the time of recognition and subsequently because these monoclonal may represent significant pathology including diseases such as multiple myeloma, low grade lymphoma or any of the diseases captured under the moniker of monoclonal gammopathy of clinical significance (MGCS), which includes\u2014but is not limited to\u2014immunoglobulin light chain amyloidosis and POEMS syndrome. Herein is a discussion of the diagnosis and follow\u2010up MGUS and MGCS.<\/jats:p>","DOI":"10.1002\/hon.70077","type":"journal-article","created":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T17:54:06Z","timestamp":1750010046000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lecture 4. 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