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Plasma cell leukemia masquerading as ALL-L3--a case report.

Kalpalata Tripathy¹, Kalyani Prava Gouda, Sukumar Chakrabarty

¹Department of Pathology, S. C.B. Medical College, Cuttack, Orissa.

Indian Journal of Pathology & Microbiology

|June 9, 2006

Summary

Plasma cell leukemia (PCL) is a rare plasma cell disorder. This case highlights PCL presenting with over 80% atypical Mott cells, mimicking Acute Lymphoid Leukemia-L3, and confirmed by bone marrow, serum, and imaging findings.

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Area of Science:

Hematology
Oncology

Background:

Plasma cell leukemia (PCL) is an aggressive plasma cell dyscrasia characterized by over 20% circulating plasma cells.
PCL is rare, often presenting with advanced disease and poor prognosis.

Observation:

A 62-year-old female presented with a peripheral smear showing over 80% atypical vacuolated plasma cells (Mott cells).
These cells morphologically mimicked Burkitt cells seen in Acute Lymphoid Leukemia-L3 (ALL-L3).
Bone marrow aspirate showed few mature myeloma cells.

Findings:

Serum protein electrophoresis revealed a positive M-band.
Skeletal X-rays demonstrated lytic lesions in the femur and pelvic bones.
A definitive diagnosis of PCL was established based on the combined clinical and laboratory findings.

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Implications:

This case underscores the importance of considering PCL in differential diagnoses, especially when atypical plasma cells are abundant.
Morphological mimicry of ALL-L3 by Mott cells in PCL necessitates comprehensive diagnostic workup.
Accurate diagnosis of PCL is crucial for appropriate treatment strategies and patient management.