Polyclonal proliferation of plasma cells associated with marked hypergammaglobulinemia in an elderly patient.
We describe an 89-year-old woman who presented with prominent plasmacytosis mimicking plasma cell leukemia. The apparent serum M-protein level of > 7 g/dL of gamma mobility was revealed to be a polyclonal increase of immunoglobulins. The plasma cells in the peripheral blood expressed polyclonal surface/cytoplasmic immunoglobulins as well as CD19, CD30, CD38, and CD138 antigens but lacked CD10, CD20, CD25, and CD56. The bone marrow plasma cells showed the CD45+, CD19+, CD56-, MPC-1(-/+), and CD49e- immunophenotype, which was in clear contrast with the immunophenotypes of the neoplastic myeloma cells. Abdominal lymphadenopathy, splenomegaly, and a high level of soluble interleukin 2 receptor may have been reflections of an underlying lymphoproliferative disorder, potentially leading to the polyclonal proliferation of plasma cells.
Ohno
Hitoshi
H
Department of Internal Medicine, Takeda General Hospital, Kyoto, Japan. hohno@k2.dion.ne.jp
Tanaka
Hideaki
H
Sakai
Hisashi
H
Katsurada
Tatsuya
T
Yoshida
Yataro
Y
D000368:Aged; D000369:Aged, 80 and over; D002455:Cell Division / Q000276:immunology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000276:immunology* / Q000473:pathology*; D010950:Plasma Cells / Q000166:cytology*
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