Plasma cells in peripheral blood smear-A diagnostic clue for Lymphoplasmacytic lymphoma
Journal Title: Pathology And Laboratory Medicine - Year 2018, Vol 9, Issue 2
Abstract
Lymphoplasmacytic lymphoma (LPL) is a chronic, B cell lymphoproliferative neoplasm with indolent clinical course. We report a rare case of a 45-year female patient presented with complaint of weakness and fever. Clinical examination showed bilateral neck lymph nodes enlargement and hepato-splenomegaly. Anemia, leukocytosis with 28% plasma cells in differential white cell count and frequent lymphoplasmacytoid cells & presence of rouleaux formation, three digit raised ESR, positive Direct coomb's test and absent Bence Jones protein in urine were significant findings. X-ray pelvic showed lytic lesion. Bone marrow examination showed 13% plasma cells. Serum immunofixation revealed monoclonal spike of IgG(kappa) type. Relation of Lymphoplasmacytic lymphoma with waldenstrom' macroglobulinemia is well known, in our case, LPL is IgG secreting rather than IgM. Immunophenotyping showed profile of lymphoplasmacytic lymphoma. We have described an unusual low grade lymphoma- LPL with IgG secreting properties with frequent presence of plasmacytic and lymphoplasmacytoid lymphocytes in peripheral blood.
Authors and Affiliations
Mayuri Thaker, Dharati Jakasania
Keywords
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