Plasma cell leukemia presenting as a pancreatic mass.
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.
Malpica
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Department of Pathology, Baylor College of Medicine, Houston, TX 77030.
Phillips
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CC
Estrada
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Banez
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EI
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