A Rare Case of Plasma Cell Leukemia: Diagnostic and Prognostic Challenges

Authors

  • Neha Kamble Assistant Professor, Department of Pathology, Dr D.Y Patil Medical College, Hospital and Research Centre, Dr D.Y Patil Vidyapeeth, Pimpri, Pune, India.
  • Rhushvi Thakkar Junior Resident, Department of Pathology, Dr D.Y Patil Medical College, Hospital and Research Centre, Dr D.Y Patil Vidyapeeth, Pimpri, Pune, India.
  • Suraj Desai Senior Resident, Department of Pathology, Dr D.Y Patil Medical College, Hospital and Research Centre, Dr D.Y Patil Vidyapeeth, Pimpri, Pune, India.
  • Charusheela Gore Professor and Head of Department, Department of Pathology, Dr D.Y Patil Medical College, Hospital and Research Centre, Dr D.Y Patil Vidyapeeth, Pimpri, Pune, India.
  • Kanishka Harariya Junior Resident, Department of Pathology, Dr D.Y Patil Medical College, Hospital and Research Centre, Dr D.Y Patil Vidyapeeth, Pimpri, Pune, India.

Keywords:

Plasma cell leukaemia, serum protein electrophoresis, Fluorescence in-situ hybridisation, TP53 mutation

Abstract

Introduction: Plasma cell leukaemia (PCL) is an uncommon and aggressive variant of Plasma cell neoplasm characterized by the presence of clonal plasma cells constituting more than 5% of the peripheral blood. PCL is more aggressive and less common than MM. While MM is primarily confined to the bone marrow, PCL often presents with extensive extramedullary involvement and higher circulating plasma cell counts. The prognosis of PCL is significantly worse than MM, with a median survival often less than a year despite novel therapies.

Case presentation: A 59-year-old seropositive (HbsAg positive) male patient, an operated case of Solitary Plasmacytoma, was later diagnosed with PCL given the presence of leucocytosis with 26% atypical plasma cells in the peripheral blood. The patient was then advised of further investigations such as serum protein electrophoresis, immunofixation studies, and Fluorescence in-situ hybridization (FISH), following which the patient was categorised as High-risk category according to Revised International Staging System for multiple myeloma (R-ISS).

Conclusion: This case report describes the difficulties in the diagnostic aspect of the entity and highlights the importance of appropriate morphological diagnosis for a better molecular prognostication.

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Published

2025-06-08

Issue

Vol. 10 No. 2 (2025)

Section

Case Report

License

 West Asia Organization for Cabcer Prevention retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License 4 (This permits anyone to copy, distribute, transmit and adapt the published work, provided the original work and source are appropriately cited).