title: Plasma cell leukemia presenting as a pancreatic mass.
abstract: A 62-year-old woman presented with a 3-week history of obstructive jaundice. Computed tomography of the abdomen showed marked enlargement of the head of the pancreas and a prominent pancreatic body, suggestive of a neoplasm with associated pancreatitis. The peripheral blood showed an increased number of plasma cells accounting for 50% of the leukocytes. Biopsy specimens of the pancreas, liver, and a peritoneal lymph node showed a diffuse infiltrate of typical and atypical plasma cells (50% of which had cytoplasmic IgG-lambda). Serum and urine protein electrophoresis revealed a monoclonal IgG-lambda spike and Bence Jones-lambda protein, respectively. The bone marrow was diffusely infiltrated by plasma cells. To our knowledge, this is the first reported case of a plasma cell leukemia presenting as a pancreatic mass producing extrahepatic biliary obstruction.
authors.affiliation: Department of Pathology, Baylor College of Medicine, Houston, TX 77030.
authors.forename: A
authors.initials: A
authors.lastname: Malpica
authors.forename: C C
authors.initials: CC
authors.lastname: Phillips
authors.forename: R E
authors.initials: RE
authors.lastname: Estrada
authors.forename: E I
authors.initials: EI
authors.lastname: Banez
mesh_terms: D002779:Cholestasis / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed