[Plasmocellular leukemia with IgD paraproteinemia]

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Plasmacytoma is a rare plasma cell neoplasm.
• Plasmacytic leukemia is an aggressive manifestation of plasma cell myeloma.
• IgD-lambda subtype is exceptionally rare.

Observation:

• An 80-year-old woman presented with symptoms initially suggestive of chronic lymphatic leukemia.
• Marked leukocytosis with significant peripheral blood plasmacytic cells aided diagnosis.
• Diagnostic confirmation involved bone marrow biopsy, cytochemistry, immunochemistry, and skeletal imaging.

Findings:

• The patient's plasmacytoma IgD-lambda transformed into plasmacytic leukemia.
• Treatment resulted in temporary clinical and laboratory remission.
• Post-mortem examination revealed widespread organ infiltration and a myelomatous kidney.

Implications:

• This case underscores the importance of considering plasmacytic leukemia in differential diagnoses of leukemic presentations.
• Diagnostic challenges associated with rare plasma cell neoplasms are highlighted.
• Understanding rare subtypes like IgD-lambda plasmacytoma is crucial for accurate diagnosis and management.