Primary nonsecretory plasma cell leukemia: a rare variant of multiple myeloma

Abstract

We report a patient with primary nonsecretory plasma cell leukemia. These cells resembled prolymphocytes and expressed only CD38 and CD56. Due to the atypical morphology and lack of monoclonal immunoglobulins in both serum and urine, it was difficult to make a correct diagnosis. Electron-microscopic and immunocytochemical cytoplasmic studies were useful.

Two Cases of Nonsecretory Multiple Myeloma Presenting as Primary Plasma Cell Leukemia

“…Immunohistochemistry, flow cytometric analyses and/or electron microscopic examination may be required to establish a definitive diagnosis. The diagnosis may be made with further difficulty in cases with a nonsecretory nature (7,9). Indeed, we did not initially suspect a diagnosis of PCL in patient 1 because most of the cells exhibited an atypical morphology, and no monoclonal proteins were detected in either the serum or urine.…”

“…Nonsecretory myeloma is also a rare form of MM characterized by the absence of monoclonal immunoglobulins on either serum or urine electrophoresis and represents less than 1% of cases of MM (4). Only a few well-documented cases of nonsecretory MM presenting as primary PCL have been reported (5)(6)(7)(8)(9). We herein report two elderly cases of primary nonsecretory PCL.…”

Primary non-secretory plasma cell leukemia with atypical morphology — a case report

“…The diagnosis may be made diffi cult further by the nonsecretory nature of plasma cell leukemia. Only 1 case of primary non secretory plasma cell leukemia with atypical morphology has been reported [3]. Here, we report another case of primary non-secretory plasma cell leukemia with atypical morphology.…”

“…Only one case of PNSPCL with atypical morphology has been reported so far [3]. Absence of a monoclonal protein in the serum and urine of patients with non-secretory PCL may be a result of (i) an inability to excrete immunoglobin (non-secretors) (ii) low synthetic capacity for immunoglobin (non-producers) (iii) increased intracellular degradation, or (iv) rapid extracellular degradation of abnormal immunoglobins [5].…”