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Rapid fatal acute peripheral T-cell lymphoma associated with IgG plasma cell leukemia and IgA hypergammaglobulinemia : case report

Simultaneous occurrence of T-cell and B-cell neoplasms is rare and etiologic relationships between these two malignancies are poorly understood. We describe a case of 66-year-old woman who was admitted to the hospital because of fever, hemoptysis, lymphadenopathy, and skin rash. Enlarged lymph nodes in the axillary, pectoral, paratracheal and periportal regions, as well as slight hepato- and splenomegaly were confirmed. Peripheral blood smear revealed rouleaux formation and numerous circulating plasma cells, with plasmacytoid lymphocytes. Immunofixation- electrophoresis detected a monoclonal band defined as IgG-lambda light chains with broad band polyclonal IgA. The patient died from abrupt splenic rupture before diagnostic work-up was finished. Postmortem examination revealed infiltration of atypical lymphoid cells exhibiting high proliferative activity admixed with typical and atypical plasma cells in several organs. Thus plasma cell leukemia (IgG-lambda) as a rare and aggressive variant of plasma cell myeloma in present case was associated with aggressive peripheral T cell lymphoma and polyclonal (IgA) plasmacytosis.

Leukemia ; plasma cell ; Lymphoma ; T cell ; Hypergammaglobulinemia

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