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HPLC-based Assay to Monitor Extracellular Nucleotide/Nucleoside Metabolism in Human Chronic Lymphocytic Leukemia Cells
Published on: July 20, 2016
[Plasmocellular leukemia with IgD paraproteinemia]
Insights
This case study details an 80-year-old woman diagnosed with IgD-lambda plasmacytoma progressing to plasmacytic leukemia. Initial lab results mimicked chronic lymphatic leukemia, highlighting diagnostic challenges in rare plasma cell disorders.
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.
Abstract:
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.
