Multiple myeloma patients with plasmablastic morphology of tumor cells and extramedullary presentation of disease often have an aggressive clinical course and resistance to chemotherapy. We describe a case of an elderly patient who presented with extramedullary, IgA-lambda-secreting multiple myeloma with plasmablastic features who demonstrated impressive clinical response to single-agent lenalidomide. This is the first description of a plasmablastic variety of multiple myeloma successfully treated with lenalidomide alone.