PMC5993264_01
a: Circulating plasma cells in the peripheral blood (Wright-Giemsa stain, original magnification x1000). b: Bone marrow diffusely infiltrated by a population of neoplastic plasma cells (Hematoxylin & Eosin stain, original magnification x400).
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Peripheral blood smear showed atypical lymphoplasmacytoid cells being > 20%, some rare blasts with no evidence of hemolysis (Fig. 1a). It showed numerous circulating atypical plasma cells and plasmablasts (>50%)(Fig. 1b).
a. b: CT abdomen without intravenous contrast and with oral contrast showing an irregular 6 cm soft tissue density mass in a non-dependent position in the stomach with an ulcerated and irregular surface.
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This revealed an irregular soft tissue density in a non-dependent position in the stomach (Fig. 2a,b).
a: Endoscopy showing a large gastric mass attached to lesser curvature with a bleeding surface. b: Endoscopy showing ulcerated, irregular and hemorrhaging surface of the gastric mass. c: Endoscopy showing lower edge of the gastric mass extending into the pylorus. d: Endoscopy showing necrotic, friable, ulcerated and bleeding surface of gastric mass. e: Endoscopy confirming evidence of active gastrointestinal bleed from the mass.
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Biopsies were taken and it was not thought to be amenable for endoscopic therapy or resection (Fig. 3a-e).