Acute plasma cell leukaemia followed by extramedullary plasmacytoma

A 54-year-old male was hospitalized because of lethargy, weight loss, an upper abdominal mass, hepatosplenomegaly and peripheral blood plasmacytosis of 66%. The diagnosis of acute plasma cell leukaemia was established, and after chemotherapy was initiated, the patient entered complete remission. 6 months later, he developed extramedullary plasmacytoma with involvement of the gastrointestinal tract, right inguinal lymph nodes and right orbit. Response to chemotherapy was poor and he died without evidence of plasma cell leukaemia. The possibility of the existence of extramedullary plasmacytoma at the onset of the disease, expressed by the appearance of plasma cell leukaemia only at the beginning and by extramedullary spreading at the terminal stage is discussed.