[Plasma cell leukemia originating with pleural effusion]

A case of plasma cell leukemia, secreting light kappa chains, is reported. It arose in a 62 year old man and was diagnosed on the basis of a bilateral pleural effusion, which showed many plasma cells and plasmoblasts. The patient also presented multiple osteolytic lesions, no adenopathies, or signs of hepatic or splenic infiltration. Cytological, cytochemical, immunological findings and serum beta 2-microglobulin assays demonstrated a highly aggressive plasmacytic proliferation. The clinical and hematological data, particularly the onset of the disease with pleural effusions, identify the case as an intermediate form between the typical plasma cell leukemia reported in the literature and anaplastic myeloma.