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Indian Journal of Pathology and Microbiology
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CASE REPORT
Year : 2020  |  Volume : 63  |  Issue : 3  |  Page : 485-487

Rare case of plasma cell myeloma with megakaryoblastic morphology mimicking acute leukemia


1 Department of Clinical Laboratory, Affiliated Hospital of Engineering University of Hebei, Hebei Province, China
2 Department of Clinical Laboratory, Affiliated Zhongshan Hospital of Dalian University, Liaoning Province, China
3 Department of Hematology, Affiliated Zhongshan Hospital of Dalian University, Liaoning Province, China
4 Department of Hematology, Affiliated Hospital of Engineering University of Hebei, Hebei Province, China

Correspondence Address:
Li Li
Department of Hematology, Affiliated Hospital of Engineering University of Hebei, Congtai Street Number 81, HanDan, Hebei Province
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPM.IJPM_282_19

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Myeloma plasma cells vary from mature forms to immature, plasmablastic, and pleomorphic cells. Only a few cases of morphologic variant of plasma cell neoplasm have been reported, in which the plasma cell neoplasm presented with lymphoplasmacytic, megakaryocytic, plasmablastic, lymphocytosis-like, and variant hairy cell leukemia-like morphological features. A 66-year-old man sought medical attention with a previous 2-month history of lower back and chest pain. Magnetic resonance imaging (MRI) of the thoracic spine showed thoracic vertebral body shape and disc degeneration, and bone lesion. Blood work showed mild anemia (hemoglobin, 101 g/L; white blood cells, 6.98 × 109/L; platelets, 146 × 109/L.), hyperuricemia (UA 671 umol/L), and immunoglobulin G kappa [IgG(κ)] paraproteins. Bone marrow study revealed diffuse invasion by sheets of megakaryoblast-like cells. Flow cytometric analysis and bone marrow biopsy revealed plasma cell myeloma (PCM), and thoracic puncture biopsy indicated plasma cell neoplasms. Overall, the findings were in accordance with a PCM. To date, this is the first reported case of PCM with megakaryoblastic morphology mimicking acute leukemia. Recognizing the morphological variant of PCM is important in differentiating it from acute leukemia.


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