Primary plasma cell leukemia presenting as a thoracic mass

Abstract

Primary Plasma cell leukaemia (pPCL) is a rare plasma cell (PC) malignancy. The strict criteria for the  diagnosis is an absolute PC number greater 2 X 109/L or a plasmocytosis accounting for > 20% of the  differential white cell count that does not arise from a pre-existing multiple myeloma. pPCL was associated with aggressive clinic-biological features. Primary Plasma cell leukaemia is more characterised by an extra  medullar involvement such as hepatomegaly, splenomegaly, lymphadenopathy, lepto-meningeal infiltration or extramedullary plasmocytomas. The prognosis of pPCL is very poor. We report the case of a fifty eight year-old man directed to the haematology department for diagnosis of pPCL revealed by a thoracic plasmocytomas  mimicking a thoracic neoplasm. The patient received chemotherapy including a classic treatment for multiple myeloma but developed a pulmonary embolism. This case illustrates an uncommon presentation of pPCL the difficulty treating by multiple myeloma chemotherapy.

Key words: Plasma cells leukaemia, thoracic mass, pulmonary embolism