AKT-3517

A 58-year-old woman presents with painless haematuria. She is a heavy smoker and has a history of chronic obstructive pulmonary disease. She previously lived in Australia and has used substantial amounts of non-steroidal anti-inflammatory drugs for arthritis and also phenacetin some years ago. Renal function testing is normal. She has a raised plasma viscosity and is anaemic with a haemoglobin of 100 g/l (115-155).
Select the most likely diagnosis to fit with this clinical picture.