Septicemia caused by the gram-negative bacterium CDC IV c-2 in an immunocompromised human

A 37-year-old man with plasma cell leukemia developed nonfatal septicemia caused by the gram-negative bacterium CDC IV c-2. Recovery followed appropriate treatment with antibiotics. The biochemical features of this organism are reviewed.

Spontaneous rupture of the spleen in primary plasma cell leukemia. Scintigraphic-pathologic correlation

A rare case of spontaneous rupture of the spleen occurring in a patient with primary plasma cell leukemia is presented. The scintigraphic-pathologic correlation is presented together with a review of the literature.

High-output cardiac failure as a presenting symptom of plasma cell leukemia

A patient presented with high-output cardiac failure and was found to have plasma-cell leukemia. No cause for the cardiac failure was found, and there was no response to treatment with diuretics and thiamine. Chemotherapy for the leukemia resulted in resolution of the cardiac failure, suggesting that the latter was caused by the leukemia--a hitherto unreported association.

[Plasma cell leukemia. Bibliographic review and ultrastructural study (by transmission and scanning electron microscopy) in 2 cases]

After a brief examination of the recent literature on plasma cell leukemia, the Authors describe the clinical features and the ultrastructural findings of the peripheral blood plasma cells, examined with transmission (T.E.M.) and scanning (S.E.M.) electron microscopes, of two patients with acute plasma cell leukemia. Both of them had a previous history of myeloma. T.E.M. confirmed the diagnostic value of the asynchronous plasma cells, and S.E.M. showed the characteristic microvilli and blebs, previously observed.

Neisseria meningitidis serogroup 29E (Z') septicemia in a patient with far advanced multiple myeloma (plasma cell leukemia)

A case of septicemia caused by Neisseria meningitidis serogroup 29E (Z') in a patient with plasma cell leukemia is described. The patient developed disseminated intravascular coagulation, had a cardiopulmonary arrest, and died. The effects of altered immune function leading to a predisposition to meningococcal infections are discussed.

[B lymphoproliferative syndrome with characteristics common to chronic lymphatic leukemia, Waldenström disease and plasmacytic leukemia]

A case of lymphoproliferative disorder presenting some features of chronic lymphocytic leukemia, Waldenström's disease and plasmacell leukemia without the full diagnostic criteria of any of these diseases is reported. It clearly demonstrates the affinity existing among the various neoplasms of the B-lymphocyte cell line.

Kappa-chain nephropathy associated with plasma cell leukemia

A 45-year-old-woman had plasma cell leukemia (PCL) and mild renal insufficiency. Renal biopsy findings were compatible with kappa-chain nephropathy. Our case adds PCL to the list of plasma cell dyscrasias associated with kappa- and/or lambda-chain nephropathy.

IgD plasma cell leukemia and uterine malignant mixed Müllerian tumor

The case of a 74-year-old female with an IgD kappa plasma cell leukemia is presented. In contrast to the majority of the cases in the literature, this patient responded rather well to melphalan and prednisolone and survived for 20 months after starting treatment. Another remarkable feature was the simultaneous occurrence of a double uterine neoplasm, a malignant mixed Müllerian tumor of the homologous variety (also called carcinosarcoma).

IgE myeloma associated with plasma cell leukaemia

A patient presented with plasma cell leukaemia and was found to have an IgE secreting multiple myeloma. IgE myeloma is very rare with only 18 cases recorded. However, this case is the fifth recorded of IgE myeloma associated with plasma cell leukaemia. Since plasma cell leukaemia only occurs in 1.6% of all cases of myeloma, it seems certain that this is a significant association.

Polyclonal lymphadenopathy presenting as plasma cell leukemia with reversible renal insufficiency

A case is reported of an elderly patient with generalized lymphadenopathy who, at presentation, showed a blood and bone marrow picture suggestive of plasma cell leukemia, polyclonal hypergammaglobulinemia restricted almost exclusively to IgA, and severe renal insufficiency. Treatment with melphalan and prednisone produced a complete remission that lasted only 1 month. A second partial remission was obtained, but the patient eventually died of heart failure. The pathological picture of the lymph nodes and spleen was intermediate between that of angioimmunoblastic lymphadenopathy (AIL) and of the plasma cell type of giant lymph node hyperplasia (Castleman's disease). The hypothesis is presented that AIL, Castleman's disease and many other polyclonal lymphadenopathies recently described in immunodeficient or elderly patients, including the present case, represent a continuous spectrum of lymphoproliferative disorders due to abnormal responses to various stimuli.

Primary plasma cell leukaemia. A case report and a review of the literature

A case history of a patient with primary plasma cell leukaemia is presented. Analysis of serum showed an IgD lambda paraprotein, and lambda-light-chains were found in the urine. Immunofluorescence studies of a bone marrow aspirate revealed intracytoplasmatic IgD of lambda-type in plasma cells. Moreover J-chain could be demonstrated in these plasma cells. A complete remission of the disease, with disappearance of the paraprotein, was obtained following treatment with a combination of cyclophosphamide, vincristine and prednisone. 12 months later, the patient developed multiple extramedullary plasmocytoma lesions in the skin. After treatment with cyclophosphamide, vincristine, doxorubicin and prednisone, another remission was achieved. The literature on the clinical features and the response to chemotherapy of primary plasma cell leukemia is reviewed.

Simultaneous presentation of plasma cell and monocytic leukemia with a subacute clinical course

A rare case of simultaneous presentation of monocytic and plasma cell leukemia is reported. Cytochemistry, transmission and scanning electron microscopy confirmed the presence of a dual population consisting of monoblasts and plasma cells. Monoblasts contained nonspecific esterases, secreted lysozyme and showed dense bodies and surface ruffles under the scanning electron microscope, while the plasma cells secreted IgG kappa paraprotein, contained rough endoplasmic reticulum, and showed surface blebs with microvilli. Another unusual feature of this case was the relatively chronic course of the disease, lasting 15 months after initial diagnosis.

Concomitant association of pyroglobulinemia and cryoglobulinemia in 2 patients in multiple myeloma

We have reported two cases of multiple myeloma associated concomitantly with pyroglobulinemia and cryoglobulinemia. One of them showed blood picture of plasma cell leukemia. Plasma cell leukemia with two abnormal serum proteins at the same time, has not been reported yet to our knowledge. In that case, the large amounts of plasma cells were detected in the urine sediment.

IgD-plasma cell leukemia associated with pyroglobulinemia and pyroglobulinuria. New types of pyroglobulin and cytoplasmic fibrils

New pyroglobulin variants were found in a patient with a typical plasma cell leukemia. One was found in the urine and proved to be a variant of Bence-Jones' protein with a molecular weight of approximately 68,000. The other was found in the serum and appears to be the myeloma protein of IgD. Furthermore, an ultrastructural study disclosed myeloma cells in both peripheral blood and bone marrow to have cytoplasmic fibrils which might be unique for plasma cell leukemia.

Ultrastructural characteristics of the plasma cells of a patient with nonsecretory myeloma and plasma cell leukemia

The clinical features and the ultrastructural findings of the bone marrow and peripheral blood plasma cells of a patient with nonsecretory myeloma and acute plasma cell leukemia are described. The internal ultrastructure of the cells was characterized by invaginated nuclei, cytoplasmic filaments and scanty endoplasmic reticulum. Scanning electron microscopy examination revealed the presence of numerous membranal buddings giving the cells a grape-like appearance. The relationship of the morphological findings to the function of the plasma cells is discussed.