TY - JOUR
T1 - Fatal cerebral hemorrhage in a patient with CD19-positive Igm-producing aggressive plasma cell myeloma, hyperviscosity syndrome and cryoglobulinemia
AU - Alatoom, Adnan
AU - Elsabrouty, Rania
AU - Willis, Jason
AU - Boils, Christie
AU - Sarode, Ravindra
AU - Hashim, Ibrahim
AU - Wang, Huan You
PY - 2009
Y1 - 2009
N2 - IgM plasma cell myeloma (PCM) is a rare entity, and CD19 positivity is found in only 1-4% of PCM. Here we report a unique case of IgM PCM, in which the plasma cells are positive for CD19. Clinically, the patient presented with hyperviscosity syndrome, mimicking the clinical manifestation of Waldenstrom's macroglobulinemia. In addition, the IgM para-protein from the patient behaved like cryoglobulins, which interfered with some of the laboratory measurements and resulted in erroneous platelet count, mean platelet volume, and serum IgM level. Despite chemotherapy, the PCM persisted and progressed to plasma cell leukemia, and the patient died of a left frontal hematoma with widespread cerebral hemorrhage extending from left lateral ventricle, third ventricle, fourth ventricle, to cisterna magna. This case represents the first CD19+ IgM-producing PCM and the second case of brain hemorrhage due to plasma cell myeloma/leukemia.
AB - IgM plasma cell myeloma (PCM) is a rare entity, and CD19 positivity is found in only 1-4% of PCM. Here we report a unique case of IgM PCM, in which the plasma cells are positive for CD19. Clinically, the patient presented with hyperviscosity syndrome, mimicking the clinical manifestation of Waldenstrom's macroglobulinemia. In addition, the IgM para-protein from the patient behaved like cryoglobulins, which interfered with some of the laboratory measurements and resulted in erroneous platelet count, mean platelet volume, and serum IgM level. Despite chemotherapy, the PCM persisted and progressed to plasma cell leukemia, and the patient died of a left frontal hematoma with widespread cerebral hemorrhage extending from left lateral ventricle, third ventricle, fourth ventricle, to cisterna magna. This case represents the first CD19+ IgM-producing PCM and the second case of brain hemorrhage due to plasma cell myeloma/leukemia.
KW - CD19
KW - Cerebral hemorrhage
KW - Cryoglobulinemia
KW - Hyperviscosity syndrome
KW - IgM plasma cell myeloma
KW - Lymphoplasmacytic lymphoma
KW - Plasma cell leukemia
KW - Waldenstrom's macroglobulinemia
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M3 - Article
C2 - 19294010
AN - SCOPUS:67149090602
SN - 1936-2625
VL - 2
SP - 498
EP - 507
JO - International Journal of Clinical and Experimental Pathology
JF - International Journal of Clinical and Experimental Pathology
IS - 5
ER -