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Title: |
Primary Plasma Cell Leukemia Mimicking an Adult T-Cell Leukemia-Lymphoma: A Case Report | |||||||||||||||||||
| Authors: | François Delhommeau, Pharm.D., Ph.D., Stéphanie Huguet, Pharm.D., Julie Gachet, M.D., Jacqueline van den Akker, M.D., and Monique Lagrange, Pharm.D. | |||||||||||||||||||
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Background: Malignant plasma cells of multiple myeloma (MM), or plasma cell leukemia (PCL), may present highly variable morphologic aspects. Adult T-cell leukemia-lymphoma (ATLL) is a peripheral T-cell neoplasm composed of highly pleomorphic lymphoid cells. We report an unusual case of primary PCL with misleading cellular morphology and some clinical and biologic similarities simulating ATLL. Case A 40-year-old Caribbean man presented with asthenia, epistaxis and diffuse bone pain. Blood cell count showed anemia and thrombocytopenia and a hyperleukocytosis composed of deeply basophilic cells with a polylobulated nucleus resembling flower cells. An ATLL diagnosis was given at first, without ruling out the possibility of a PCL diagnosis. Hypercalcemia and lytic bone lesions were compatible with both diagnoses. Immunophenotyping was key to the diagnosis of primary PCL. Conclusion: Some clinical and biological overlap may exist between PCL and ATLL, leading to a false diagnosis or delaying a correct one. An accurate cytologic analysis leading to a rapid detection of plasma cell markers is essential for an early diagnosis. (Acta Cytol 2010;54:187–189) |
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| Keywords: | multiple myeloma; plasma cell leukemia; T-cell leukemia-lymphoma, adult | |||||||||||||||||||
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