Primary plasma cell leukaemia--a case report.

Plasma cell leukemia is a rare disease entity where the number of clonal plasma cells in the peripheral blood exceeds 2X10 9 /l or 20% of the total leukocyte count. This plasma cell leukemia can be primary which is arising denovo or secondary as in the course of plasma cell myeloma. A 40 year old female who came to the outpatient department with complaints of low back pain for 3 months and had hepatosplenomegaly. Patient was investigated for the same and the peripheral smear showed 20% plasmacytoid cells. Multiple lytic lesions were noted in x ray skull. Bone marrow aspirate and biopsy revealed a hyper cellular marrow. Marrow showed chiefly plasma cells (56%) with many binucleate, trinucleate forms and multinucleate forms resembling tumour giant cells were noted. Marrow elements were decreased. Chemotherapy was initiated and the patient had successfully completed four cycles. This case is presented because of its rarity, presenting at a younger age, primary type of plasma cell leukemia, presence of organomegaly and unique morphology of the cells in the blood and bone marrow.