title: Utility of hematology analyzer and flow cytometry in timely and correct detection of circulating plasma cells: Report of three cases.
abstract: Circulating neoplastic plasma cells (PCs) are a common feature between classical plasma cell myeloma (PCM) and its aggressive variant, plasma cell leukemia (PCL), with their early suspicion and detection being of clinical importance for prognostic and diagnostic purposes.
  
  
  
  Morphological and flow cytometric enumeration and characterization of peripheral blood (PB) neoplastic PCs were performed in 3 PCM patients after complete blood count (CBC) evaluation.
  
  
  
  Early suspicion of circulating PCs by initial CBC scatter plots and monocytosis led to morphological enumeration of PCs, with low level of concordance between morphologists. Flow cytometric PB analysis permitted accurate quantification and characterization of circulating clonal PCs.
  
  
  
  CBC findings can prompt early suspicion of circulating PCs in PCM patients leading to early and accurate flow cytometric analysis of clonal PCs in addition to morphological PB evaluation. The suggested combined approach proved to be most important in the PCL case with discordant morphological evaluations and marginal PC numbers according to current criteria. © 2016 International Clinical Cytometry Society.
authors.affiliation: Immunology Department, Microbiology Laboratory, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Gounari
authors.affiliation: Immunology Department, Microbiology Laboratory, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Tsavdaridou
authors.affiliation: Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Triantafyllia
authors.initials: T
authors.lastname: Koletsa
authors.affiliation: Haematology Department, Microbiology Laboratory, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Androula
authors.initials: A
authors.lastname: Nikolaidou
authors.affiliation: Haematology Department, First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Kaiafa
authors.affiliation: Haematology Department, First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Papaioannou
authors.affiliation: Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kostopoulos
authors.affiliation: Immunology Department, Microbiology Laboratory, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Lemonia
authors.initials: L
authors.lastname: Skoura
mesh_terms: D000368:Aged; D001772:Blood Cell Count / Q000379:methods; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006405:Hematology / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D010950:Plasma Cells / Q000473:pathology*; D011379:Prognosis
keywords: flow cytometry; hematology analyzer; plasma cell leukemia; plasma cell myeloma