Case Of Plasma Cell Myeloma Research Articles

A Rare Case of Plasma Cell Myeloma, Myelodysplastic Neoplasm with Low Blast and SF3B1 Mutation and Dyserythropoiesis with Ring Sideroblasts

Myelodysplastic syndromes (MDS) are heterogeneous hematological neoplasms which lead to dysplasia, cytopenia and hematopoiesis. They have a risk of transforming into Acute Myeloid Leukemia (AML) in some cases. Genetic markers that are determined by cytogenetics, SNP-A karyotyping and molecular mutations have evolved to define conditions of pathogenesis and risk evaluation for the development of AML. Among the concerned are the mutations of the spliceosome (SF3B1, SRSF2, ZRSR2 and U2AF1) epigenetic mutations (DNMT3A, EZH2) and also mutations in transcription factors (RUNX1) and tyrosine kinases (N-RAS, K-RAS). Here, we report a case of an 80-year-old female patient presented for the evaluation of myeloma. A morphology report shows changes that suggest multiple myeloma. Lab data shows anemia, elevated creatinine and calcium; CBC revealed mild neutrophilic leukocytosis and microcytic anemia. Bone marrow demonstrated approximately 50-60% involvement by a plasma cell infiltrate; there was mild dysgranulopoiesis and dyserythropoiesis which are suggestive of plasma cell myeloma. Frequent mutations in MDS and overlap syndromes were discovered due to advances in genomic studies. The differential diagnosis of MDS is challenging because they overlap the disorders sharing features of other illnesses. It is expected that more research on MDS and overlapping disorders will highlight the roles of mutations as “therapeutic targets” and “prognostic indicators”.

A Case of Plasma Cell Myeloma with Multilobated and Monocytoid Morphology

Plasma cell myeloma (PCM) accounts for approximately 1% of malignant tumors and 10 to 15% of hematological neoplasms. It is a malignant disease characterized by abnormal proliferation of plasma cells and monoclonal immunoglobulins or free light chains (FLCs). There are many morphological variations of the myeloma plasma cells which include mature, immature, plasmablastic, and pleomorphic types. Here, we report a rare presentation of PCM with normal serum protein electrophoresis but elevated serum FLCs and having convoluted, multilobated, and monocytoid morphology. This type of morphology is related to an aggressive clinical course and resistance to conventional chemotherapy. Moreover, absence of M protein in serum/urine electrophoresis does not rule out the diagnosis of PCM and serum FLC assays plays an important role in this kind of scenarios.

Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology

Background: Extramedullary plasmacytoma (EMP) of the thyroid is a rare neoplasm that may present either as a solitary plasmacell tumor or involvement of plasma cell myeloma (PCM). In this report, we present a unique case of PCM presented as a thyroid mass without previous history, and initially misinterpreted as medullary carcinoma on fine-needle aspiration cytology (FNAC). Case Presentation: A 77-year-old female presented with shortness of breath and palpitation. Ultrasonography-guided FNAC from the large thyroid mass revealed hypercellular smears composed of monomorphic plasmacytoid cells, focally binucleated, scattered diffusely. Subsequent histopathological examination and immunohistochemistry of thyroidectomy specimen showed infiltration of sheets of plasma cells and diagnosed as EMP. Histology of the bone marrow displayed Lambda positive neoplastic plasma cells. A combination of singly distributed cells and aggregates with plasmacytoid morphology on a proteinous background without clinical suspicion and previous history leads to misinterpretation of FNAC. Conclusion: Clinical correlation, immunocytochemistry, and complementary cytological approach including various preparation techniques of staining are crucial for avoiding diagnostic pitfalls and the patients’ proper treatment.

Type III ABO discrepancy aiding in diagnosis of multiple myeloma

Plasma cell myeloma is characterized by monoclonal proliferation of plasma cells, causing destructive bone lesions and other systemic manifestations. The disease spans a clinical spectrum from asymptomatic to highly aggressive disease. M protein caused by myeloma cells results in type III ABO discrepancy, in which rouleaux formation can be misinterpreted as agglutination. We present a case of a 54year old male admitted in our hospital with breathlessness, severe pallor and fever. Blood transfusions were advised as the haemoglobin was low. Initially there was a discrepancy between forward and reverse grouping which resolved with saline washes. On further investigations like peripheral smear and bone marrow examination, the patient was diagnosed as a case of plasma cell myeloma. In our case the blood grouping revealed type III ABO discrepancy which upon further investigation was found to be a case of plasma cell myeloma. Key Messages: Plasma cell myeloma has varied presentations. In our case, the patient presented with severe anaemia, plasma cells in peripheral blood and type III ABO discrepancy. Rouleaux formation should not be interpreted as agglutination. Careful vigilance by technicians in blood bank and thorough knowledge regarding various discrepancies will help in the management of the patient. Keywords: ABO discrepancy, Agglutination, Anaemia, Plasma cell myeloma, Rouleaux.

Diagnostic and treatment hurdles in plasma cell myeloma with t(11;14) translocation: A case report.

t(11;14) translocation is one of the most common chromosomal abnormalities in plasma cell myeloma. The present case report presented a case of plasma cell myeloma with t(11;14) translocation, in which the plasma cells were small lymphoplasmacytoids in morphology with positive cluster of differentiation-20 and Cyclin D1 expression. These results led to initial diagnostic difficulties. The patient was refractory to bortezomib-based therapy, and responsive to vincristine, doxorubicin and dexamethasone. However, the prognostic value of t(11;14) in plasma cell myeloma remains to be determined. With recent advances in treatment options, physicians should be aware of the clinical and pathological characteristics of this translocation in plasma cell myeloma.

A Rare Occurrence of Plasma Cell Myeloma with Biclonal Gammopathy

Plasma cell myeloma is known to cause expansion of a single clone of immunoglobulin (Ig) which results in the secretion of a unique homogeneous monoclonal protein (M component). However, there are cases which reported that it can also cause production of two different clones of these monoclonal M proteins. Although it is relatively very rare as the prevalence is only 2% of all plasma cell myeloma cases, the clinical features are said to be similar to monoclonal gammopathy. It is suggested that these biclonal gammopathy results from either one monoclonal cell clone in monoclonal gammopathy or two different monoclonal cell clones. Whichever the mechanism of the disease be, the response to treatment seems to be similar as compared to the monoclonal cases although some reports shows chemoresistant. Here, we report a rare case of plasma cell myeloma with IgG (lambda) and IgA (lambda) type of biclonal gammopathy, the clinical presentation, the haematological and biochemical markers as well as the response to the treatment.

An Unusual Case of Plasma Cell Myeloma With Concurrent Follicular Lymphoma

An Unusual Case of Plasma Cell Myeloma With Concurrent Follicular Lymphoma

A Case of Acute Promyelocytic Leukemia Concomitant with Plasma Cell Myeloma

A Case of Acute Promyelocytic Leukemia Concomitant with Plasma Cell Myeloma

Plasma Cell Myeloma Initially Presenting as Lung Cancer

Sun Young Cho, M.D., Jae-Heon Jeong, M.D., Woo-In Lee, M.D., Juhie Lee, M.D., Il Ki Hong, M.D., Jin-Tae Suh, M.D., Hee Joo Lee, M.D., Hwi-Joong Yoon, M.D., and Tae Sung Park, M.D.. Ann Lab Med 2013;33:225-8. https://doi.org/10.3343/alm.2013.33.3.225

Plasma Cell Myeloma with Unusual Expression of CD19, CD10, CD45 and Surface Light Chain in a Human Immunodeficiency Virus Positive Patient

A 52-year-old male with a history of Human Immunodeficiency Virus (HIV) infection presented with acute renal failure, hypercalcemia, anemia, and cervical lymphadenopathy. Serum protein electrophoresis demonstrated an IgG kappa monoclonal protein and bone scan demonstrated multiple lytic bone lesions. Given patient history/clinical presentation of HIV infection and cervical lymphadenopathy, differential diagnosis includes plasma cell myeloma, B cell lymphoma with extensive plasmacytic differentiation, plasmablastic lymphoma and HHV-8 associated large B cell lymphoma. Flow cytometry of the bone marrow aspirate showed a CD19 positive/CD20 negative population with high side scatter and co expression of CD45, CD10, CD56, and surface kappa light chain. Bone marrow biopsy/clot showed sheets of atypical plasmacytic cells. Immunohistochemical stains showed these atypical plasmacytic cells were positive for CD138, CD79a, CD56, MUM-1, CD19, CD10 and kappa light chain; negative for CD20, PAX-5, HHV-8, EBV and EBER in situ hybridization. Ki-67 demonstrated a low proliferation index in these atypical cells. Cytogenetic study showed a normal male karyotype. All things considered, including clinical presentation, morphologic and immunophenotypic features, it represents a unique case of plasma cell myeloma with unusual expression of CD19, CD10, CD45, and surface light chain.

Plasma cell myeloma infiltrating the dental pulp: An interesting finding

Plasma cell myeloma (PCM) is a clonal neoplastic proliferation of terminally differentiated B lymphocytes (plasma cells/myeloma cells) that involves the skeletal system in a multifocal fashion. Even though jaw involvement has been reported in as many as 30% of cases, myeloma cells infiltrating into the pulpal tissue is extremely rare. Here, we present a case of PCM in which myeloma cells are seen infiltrating into the pulpal tissue of 46.

English

The presence of crystalline inclusions in plasma cell myeloma is a rare phenomenon and cases have been reported with rod, needle, and rectangular shaped crystals in the bone marrow. Here, we present a case of plasma cell myeloma with intracellular crystalline eosinophilic inclusions and extracellular crystal depositions in the bone marrow. Since crystal depositions can be seen in many other clinical conditions, this case invites consideration of plasma cell myeloma in the differential diagnosis of patients with crystalline deposition in the

Plasma Cell Myeloma Presenting as Abnormal Uterine Bleeding

We report a case of a 53-year-old woman who presented with anemia and abnormal uterine bleeding. Endometrial and cervical biopsies revealed infiltration by large atypical cells, which were characterized as neoplastic plasma cells. Further investigations revealed systemic plasma cell dyscrasia (i.e., plasma cell myeloma). We therefore report a case of plasma cell myeloma, initially presenting as abnormal uterine bleeding.

PLASMA CELL MYELOMA OF THE PHARYNX AND CERVICAL REGION WITHOUT SKELETAL INVOLVEMENT

Multiple myeloma essentially represents a malignant neoplastic disease of the bone marrow which rarely, if ever, metastasizes. We are reporting a case of plasma cell myeloma of the pharynx and cervical region without apparent skeletal involvement. REPORT OF CASE A man, aged 60, came to the clinic on April 30, 1930. He had first noticed a swelling in his throat and in the right side of his neck two or three months previously. There was slight difficulty in swallowing and breathing but no pain. General examination gave essentially negative results, except for obesity, chronic myocardial degeneration and a moderate degree of hypertension. Examination of the throat revealed an ulcerated, polypoid mass about 3 by 2.5 cm. in the right side of the pharynx which apparently originated in the tonsil. There was also a mass in the right upper cervical region 4 cm. in diameter. Roentgenograms of the