Article

Plasma cell leukemia producing monoclonal immunoglobulin E.

Department of Clinical Laboratories, Saku Central Hospital, 197 Usuda, Saku, Nagano, 384-0301, Japan.
International journal of hematology (impact factor: 1.17). 09/2009; 90(3):402-6. DOI:10.1007/s12185-009-0407-1
Source: PubMed

ABSTRACT A 78-year-old male with lumbar pain and dim consciousness presented the clinical pictures of plasma cell leukemia (PCL) producing a large amount of monoclonal immunoglobulin E (IgE)/kappa protein. Laboratory investigation demonstrated an elevated serum calcium level and renal dysfunction. Systemic bone X-ray survey disclosed only a solitary osteolytic lesion. Circulating plasma cells demonstrated CD19(-)/CD56(-) and MPC-1(-)/CD49e(-)/CD45(+/-), the latter indicating the immature phenotype of the tumor cells. Bone marrow was occupied with immature, atypical plasma cells, of which cytoplasms were positive for IgE by direct immunofluorescence analysis. Chromosomes revealed a translocation of (11;14)(q13;q32), which is concordant with cyclinD1-protein overexpression by immunohistochemistry. He was treated with dexamethasone and vincristine, which somewhat improved the laboratory findings. He died of tumor progression after 4-month admission. The clinical and biological characteristics of IgE-producing PCL, a very rare type of plasma cell dyscrasia, are discussed, reviewing the past literature.

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Keywords

4-month admission
 
atypical plasma cells
 
biological characteristics
 
Bone marrow
 
Circulating plasma cells
 
clinical pictures
 
cyclinD1-protein overexpression
 
elevated serum calcium level
 
IgE
 
IgE)/kappa protein
 
IgE-producing PCL
 
immature phenotype
 
large amount
 
lumbar pain
 
plasma cell dyscrasia
 
plasma cell leukemia
 
rare type
 
renal dysfunction
 
Systemic bone X-ray survey
 
tumor cells
 

Yuzuru Takemura