All of the following are characteristic of bone marrow in Waldenstrom's macroglobulinemia EXCEPT?

In Waldenstrom's macroglobulinemia, the bone marrow typically exhibits an increase in plasma cells due to the disease's association with monoclonal immunoglobulin production, which characterizes this condition. This means that options indicating increased plasma cells and conditions associated with hyperviscosity, such as marked rouleaux formation, are consistent with the disease's pathophysiology.

Moreover, there is often a relative or absolute lymphocytosis observed in patients because the condition involves an abnormal proliferation of small, mature lymphocytes, specifically affecting B-cells.

In contrast, an increase in megakaryocytes is not a characteristic feature of Waldenstrom's macroglobulinemia. Megakaryocytes are the precursor cells for platelets, and their proliferation is typically associated with other conditions, such as primary myelofibrosis or essential thrombocythemia, rather than Waldenstrom's macroglobulinemia. Thus, the statement regarding increased megakaryocytes is not consistent with the patterns expected in bone marrow from patients with Waldenstrom's macroglobulinemia, making it the exception among the characteristics listed.