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[Myeloid pseudo-splenomegaly in a patient with a myeloma]
L Védrine1, E Boucher, T Samson
1Service d'hématologie clinique, Hôpital d'instruction des armées Percy, Clamart, France. lmvt@wanadoo.fr
Introduction:
Lymphoproliferative syndromes are rarely complicated by medullar fibrosis simulating myeloid splenomegaly.
Observation:
We report an unusual case of an IgD myeloma revealed in a context of myeloid splenomegaly in a 37 year-old man, initially admitted for severe anaemia associated with a voluminous splenomegaly.
Commentaries:
The occurrence of myeloid splenomegaly during myeloma is extremely rare and only 14 cases have been reported. In this context, myelofibrosis is secondary to plasmocyte invasion of the bone marrow and regresses, or disappears, following specific treatment of the myeloma. The hypothesis evoked to explain the appearance of a secondary myelofibrosis is the "inappropriate" secretion, by the malignant plasmocyte clone, of functional analogs of pro-fibrosis cytokines, usually secreted by the mega-caryocyte precursors implied in myeloid splenomegaly.