PMC7781713_01
CT scan showing lytic bone lesions.
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Bone survey and computed tomography scan (CT scan) findings were consistent with multiple lytic lesions in the vertebrae (Figure 1) and hepatosplenomegaly.
Plasma cells in bone marrow aspirate smear.
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Bone marrow biopsy showed >90% kappa-restricted plasma cells, which were CD 138 positive by immunohistochemistry (Figures 2 and 3).
Bone marrow CD 138 IHC stain.
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Bone marrow biopsy showed >90% kappa-restricted plasma cells, which were CD 138 positive by immunohistochemistry (Figures 2 and 3).
Circulating plasma cells in peripheral blood smear.
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Peripheral smear showed 55% plasma cells leading to the diagnosis of IgM pPCL (Figure 4).
Serum monoclonal proteins.
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IgM level decreased to 200 mg/dL, M protein to 0.2 gm/dL, and bone marrow plasma cells to 3%, with no peripheral plasma cells (Figures 5 and 6).
Ig M levels.
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IgM level decreased to 200 mg/dL, M protein to 0.2 gm/dL, and bone marrow plasma cells to 3%, with no peripheral plasma cells (Figures 5 and 6).