Leucemia plasmacellulare: primo inquadramento diagnostico in laboratorio

Le résumé fourni par la source

The laboratory hematology represents an indispensable aid to clinical hematology. The clinical case of a 66-year-old woman admitted to the emergency department for non-specific symptomatology characterized by fever, asthenia and dyspnea on exertion is reported here. The CBC and DIFF examination was altered with regard to both the numerical and the morphological parameters. In-depth microscopic examination confirmed the presence of abnormal cells, some with cytoplasmic extroversions, sometimes binucleated, attributable to atypical plasma cells. The finding of these alterations induced the evaluation of the leukocyte immunophenotype, which documented that 78% of the cellularity was represented by CD13+ plasma cells, co-expressing CD38, CD138 and MDR. A relevant monoclonal component, IgG lambda, of 5.4 g/dL was detectable. Further diagnostic investigation (biochemical analysis, bone marrow examination), led to the diagnosis of primary plasma cell leukemia, a rare, prognostically unfavorable form of plasma cell dyscrasia. Taking into account their speed of performance, availability, and cost-effectiveness, the complete blood count with differential and microscopic smear examination, performed with adequate resources and expertise, represent valuable sources of information for identifying cases worthy of further investigation.

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