Journal of Applied Hematology

IMAGE IN HEMATOLOGY
Year
: 2018  |  Volume : 9  |  Issue : 1  |  Page : 37--38

Plasma cell leukemia with a multiple auer rod-like


Adnan Alkhayat 
 Department of Pathology and Laboratory Medicine, Hematology Unit, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Dr. Adnan Alkhayat
Department of Pathology and Laboratory Medicine, Hematology Unit, King Saud University Medical City, College of Medicine, King Saud University, P. O. Box: 89885, Riyadh 11692
Saudi Arabia




How to cite this article:
Alkhayat A. Plasma cell leukemia with a multiple auer rod-like.J Appl Hematol 2018;9:37-38


How to cite this URL:
Alkhayat A. Plasma cell leukemia with a multiple auer rod-like. J Appl Hematol [serial online] 2018 [cited 2022 Sep 28 ];9:37-38
Available from: https://www.jahjournal.org/text.asp?2018/9/1/37/228335


Full Text

A 64-year-old female, a known case of diabetes mellitus, hypertension, dyslipidemia, vertebral fracture, and asthma, presented in emergency room with palpitation. Laboratory studies were remarkable for anemia (hemoglobin, 77 g/L), thrombocytopenia (platelets, 112 × 109/L), and normal white blood cell (WBC) count (WBC 7.4 × 109/L). Peripheral blood smear shows many abnormal cells (32% of all WBCs) with multiple Auer rod-like inclusions of cytoplasm presented in clusters but the overall features, morphologically, in favor of plasma cells [[Figure 1], panel a-d]. Serum protein electrophoresis shows monoclonal gamma globulin (37.34 g/L). Kappa free light chain (FLC) 4660 mg/L, lambda FLC 46.3 mg/L, K/L ratio 100.65, creatinine 167 mmol/L, and calcium 2.62 mmol/L. Initial flow cytometric studies, which were done on peripheral blood and bone marrow aspirate, revealed monoclonal plasma cells expressing CD38, CD138, CD56, and kappa light chain and negative for CD19, CD20, and lambda light chain. In addition, plasma cells were highlighted by CD138, kappa light chain restriction [[Figure 1], panel e], and CD56 [[Figure 1], panel f] by immunohistochemistry. Cytogenetic study was done by fluorescence in situ hybridization and revealed a negative results for 17p13.1 (TP53), 13q14.3 deletions (D13S319), t (11; 14) (IGH/CCND1), t (4; 14) (IGH/FGFR3), and t (14; 16) (IGH/MAF) gene rearrangement.{Figure 1}

Plasma cell leukemia diagnosed when clonal plasma cells >20% of total leukocytes in the blood or the absolute count is >2 × 109/L. Few cases have been reported of the presence of Auer rod-like inclusion in plasma cell neoplasm. These cases could be mistaken with acute myeloid leukemia, and thus, immunophenotyping is essential to differentiate in such cases.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.