[Plasma cell leukemia with amyloid deposition and osteogenetic change at the site of an extramedullary plasmacytoma].
A 49-year-old man was admitted with swelling in the left lower extremity, and a mass in the left lower abdomen. Laboratory findings showed an increased WBC of 15,000/microliter with 41% plasma cells, and immunoglobulin (Ig) A of 2,557mg/dl with a monoclonal component. A roentgenogram and computed tomograph of the abdomen revealed that a 5 x 10 cm mass with calcification located in the iliopsoas muscle. Plasma cell leukemia with extramedullary plasmacytoma was diagnosed, and the patient was treated with high-dose dexamethasone (40 mg/day for 4 days), resulting in a good response with the disappearance of plasma cells in peripheral blood and a marked decrease in serum Ig A. However, the patient's condition deteriorated in spite of various treatments, and he died of heart failure 5 months after admission. With informed consent from relatives, a necropsy was performed and infiltration of plasma cells in the mass in the iliopsoas muscle was noted. We reported this case because plasma cell leukemia with amyloid deposition and osteogenesis at the site of extramedullary plasmacytoma is very rare.
Kurosu
T
T
First Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University.
Sakashita
C
C
Yamamoto
K
K
Tohda
S
S
Miki
T
T
Koyama
T
T
Miura
O
O
Murakami
N
N
Nemoto
T
T
Miyasaka
N
N
Kamiyama
R
R
Hirosawa
S
S
D000682:Amyloid / Q000378:metabolism*; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology* / Q000503:physiopathology; D010012:Osteogenesis
D000682:Amyloid