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Florid plasmacytosis in a case of acute myeloid leukemia: A diagnostic dilemma
Aruna Rangan1, Bhavna Arora, Pooja Rangan
1Department of Hematology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India.
Abstract:
The association of acute myeloid leukemia (AML) with plasmacytosis is a known, although rare event. There are very few case reports documenting an increase in the number of plasma cells at the time of AML diagnosis. Here, we present the case of a 65-year-old male diagnosed as acute myelomonocytic leukemia with exuberant plasmacytosis, which posed a difficulty in diagnosis. Paracrine interleukin-6 production by leukemic blast cells is thought to contribute to this associated reactive plasma cell proliferation.
Insights
Acute myeloid leukemia (AML) rarely presents with plasmacytosis. This case highlights a diagnostic challenge in acute myelomonocytic leukemia with significant plasma cell proliferation, potentially driven by interleukin-6.
Area of Science:
- Hematology
- Oncology
- Cell Biology
Background:
- Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy.
- Plasmacytosis, an increase in plasma cells, is an uncommon finding at AML diagnosis.
- Reactive plasmacytosis can complicate the diagnostic process of hematologic disorders.
Observation:
- A rare case of acute myelomonocytic leukemia (AMML) co-occurring with marked plasmacytosis is presented.
- The patient was a 65-year-old male.
- The exuberant plasmacytosis presented diagnostic challenges.
Findings:
- Leukemic blast cells are implicated in driving reactive plasma cell proliferation.
- Paracrine production of interleukin-6 (IL-6) by leukemic blasts is the suspected mechanism.
- This IL-6 signaling pathway may explain the observed plasmacytosis in AML.
Implications:
- Understanding the interplay between leukemic cells and plasma cells is crucial for accurate AML diagnosis.
- Targeting IL-6 pathways could be a potential therapeutic strategy in specific AML subtypes.
- This case underscores the importance of considering rare presentations in hematologic malignancies.
