[Plasmocellular leukemia with IgD paraproteinemia]

The authors describe the case of an 80-year-old woman with a plasmocytoma IgD-lambda, which developed into plasmocellular leukaemia. The laboratory finding reminded at first of chronic lymphatic leukaemia. The correct diagnosis was assisted by marked leucocytosis with the release of a major number of plasmatic cells into the peripheral blood stream. The finding was confirmed on the basis of sternal puncture, cytochemical examination, immunochemical examination of the blood and urine and X-ray of the skull. Treatment led to marked clinical and laboratory improvement. The patient died, however, from pneumonia three months after establishment of the diagnosis. Post-mortem examination revealed an extensive infiltration of many organs and a myelomatous kidney. The authors present some differential diagnostic reflections on plasmocellular leukaemia.