title: Plasma cell leukemia producing monoclonal immunoglobulin E.
abstract: A 78-year-old male with lumbar pain and dim consciousness presented the clinical pictures of plasma cell leukemia (PCL) producing a large amount of monoclonal immunoglobulin E (IgE)/kappa protein. Laboratory investigation demonstrated an elevated serum calcium level and renal dysfunction. Systemic bone X-ray survey disclosed only a solitary osteolytic lesion. Circulating plasma cells demonstrated CD19(-)/CD56(-) and MPC-1(-)/CD49e(-)/CD45(+/-), the latter indicating the immature phenotype of the tumor cells. Bone marrow was occupied with immature, atypical plasma cells, of which cytoplasms were positive for IgE by direct immunofluorescence analysis. Chromosomes revealed a translocation of (11;14)(q13;q32), which is concordant with cyclinD1-protein overexpression by immunohistochemistry. He was treated with dexamethasone and vincristine, which somewhat improved the laboratory findings. He died of tumor progression after 4-month admission. The clinical and biological characteristics of IgE-producing PCL, a very rare type of plasma cell dyscrasia, are discussed, reviewing the past literature.
authors.affiliation: Department of Clinical Laboratories, Saku Central Hospital, 197 Usuda, Saku, Nagano, 384-0301, Japan. yuzurutakemura@nifty.com.|Department of Internal Medicine, Saku Central Hospital, Saku, Japan. yuzurutakemura@nifty.com.
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Takemura
authors.affiliation: Department of Clinical Laboratories, Saku Central Hospital, 197 Usuda, Saku, Nagano, 384-0301, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Department of Clinical Laboratories, Saku Central Hospital, 197 Usuda, Saku, Nagano, 384-0301, Japan.|Department of Biomedical Laboratory Sciences, School of Health Sciences, Shinshu University, Matsumoto, Japan.
authors.forename: Kahori
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Clinical Laboratories, Saku Central Hospital, 197 Usuda, Saku, Nagano, 384-0301, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakazawa
authors.affiliation: Department of Internal Medicine, Saku Central Hospital, Saku, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Department of Internal Medicine, Saku Central Hospital, Saku, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Mitsuishi
authors.affiliation: Department of Clinical Pathology, Saku Central Hospital, Saku, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishigame
authors.affiliation: Department of Biomedical Laboratory Sciences, School of Health Sciences, Shinshu University, Matsumoto, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kameko
authors.affiliation: Department of Medical Crisis Management, Chiba Institute of Science, Choshi, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fujita
authors.affiliation: Division of Hematopathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Ichinohasama
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000097:blood*; D001859:Bone Neoplasms / Q000276:immunology* / Q000473:pathology; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007145:Immunoglobulin kappa-Chains / Q000097:blood*; D007952:Leukemia, Plasma Cell / Q000276:immunology* / Q000473:pathology; D008297:Male
chemical_list: D000911:Antibodies, Monoclonal; D007145:Immunoglobulin kappa-Chains; D007073:Immunoglobulin E