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Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature

Patient: Male, 22-year-old Final Diagnosis: Anaplastic plasma cell myeloma Symptoms: Bone pain Medication:— Clinical Procedure: BM examination Specialty: Hematology OBJECTIVE: Unusual clinical course BACKGROUND: Plasma cell myeloma is a neoplastic plasma cell disorder that usually presents after the...

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Autores principales: Elsabah, Hesham, Soliman, Dina S., Ibrahim, Feryal, Al-Sabbagh, Ahmad, Yassin, Mohamed, Moustafa, Abbas, Nashwan, Abdulqadir M., Nawaz, Zafar, ElOmri, Halima M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081950/
https://www.ncbi.nlm.nih.gov/pubmed/32152261
http://dx.doi.org/10.12659/AJCR.920489
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author Elsabah, Hesham
Soliman, Dina S.
Ibrahim, Feryal
Al-Sabbagh, Ahmad
Yassin, Mohamed
Moustafa, Abbas
Nashwan, Abdulqadir M.
Nawaz, Zafar
ElOmri, Halima M.
author_facet Elsabah, Hesham
Soliman, Dina S.
Ibrahim, Feryal
Al-Sabbagh, Ahmad
Yassin, Mohamed
Moustafa, Abbas
Nashwan, Abdulqadir M.
Nawaz, Zafar
ElOmri, Halima M.
author_sort Elsabah, Hesham
collection PubMed
description Patient: Male, 22-year-old Final Diagnosis: Anaplastic plasma cell myeloma Symptoms: Bone pain Medication:— Clinical Procedure: BM examination Specialty: Hematology OBJECTIVE: Unusual clinical course BACKGROUND: Plasma cell myeloma is a neoplastic plasma cell disorder that usually presents after the fifth decade of life; it is rarely described in younger population especially under 30 years of age. However, there are conflicting reports in the literature about the clinical behavior and overall survival in younger age groups. In approximately 2% of plasma cell myeloma, the morphology of the neoplastic cells is highly pleomorphic, quite anaplastic, and may resemble metastatic tumor cells. While this poses a challenge for morphological interpretation during diagnosis, it has been demonstrated that bone marrow morphologic features (including diffuse sheet growth pattern, immature cell morphology and high mitotic index) significantly correlates with high risk disease. Moreover, there is limited description available about the morphology of the neoplastic cells when correlating the age at presentation with the clinical outcome/biological behavior; hence, the need to report and collect such cases. CASE REPORT: We report a case of plasma cell myeloma in a 22-year-old male who presented with non-specific clinical features and posed a diagnostic challenge during clinical, radiological, and laboratory examination. The pathology specimens showed anaplastic morphology. Unfortunately, after diagnosis, despite treatment with brotezomib, his disease had an aggressive clinical course and he passed away 4 months after diagnosis. CONCLUSIONS: Although plasma cell myeloma is rare in patients younger than 30 years, it must be considered in the differential diagnosis and investigated properly especially in patients with clinical suspicion of a metastatic non-hematological tumor. The anaplastic variant in a young patient is a diagnostic challenge and is associated with bizarre morphology, aggressive presentation, adverse cytogenetics, resistance to chemotherapy, and poor, short-term, survival.
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spelling pubmed-70819502020-03-25 Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature Elsabah, Hesham Soliman, Dina S. Ibrahim, Feryal Al-Sabbagh, Ahmad Yassin, Mohamed Moustafa, Abbas Nashwan, Abdulqadir M. Nawaz, Zafar ElOmri, Halima M. Am J Case Rep Articles Patient: Male, 22-year-old Final Diagnosis: Anaplastic plasma cell myeloma Symptoms: Bone pain Medication:— Clinical Procedure: BM examination Specialty: Hematology OBJECTIVE: Unusual clinical course BACKGROUND: Plasma cell myeloma is a neoplastic plasma cell disorder that usually presents after the fifth decade of life; it is rarely described in younger population especially under 30 years of age. However, there are conflicting reports in the literature about the clinical behavior and overall survival in younger age groups. In approximately 2% of plasma cell myeloma, the morphology of the neoplastic cells is highly pleomorphic, quite anaplastic, and may resemble metastatic tumor cells. While this poses a challenge for morphological interpretation during diagnosis, it has been demonstrated that bone marrow morphologic features (including diffuse sheet growth pattern, immature cell morphology and high mitotic index) significantly correlates with high risk disease. Moreover, there is limited description available about the morphology of the neoplastic cells when correlating the age at presentation with the clinical outcome/biological behavior; hence, the need to report and collect such cases. CASE REPORT: We report a case of plasma cell myeloma in a 22-year-old male who presented with non-specific clinical features and posed a diagnostic challenge during clinical, radiological, and laboratory examination. The pathology specimens showed anaplastic morphology. Unfortunately, after diagnosis, despite treatment with brotezomib, his disease had an aggressive clinical course and he passed away 4 months after diagnosis. CONCLUSIONS: Although plasma cell myeloma is rare in patients younger than 30 years, it must be considered in the differential diagnosis and investigated properly especially in patients with clinical suspicion of a metastatic non-hematological tumor. The anaplastic variant in a young patient is a diagnostic challenge and is associated with bizarre morphology, aggressive presentation, adverse cytogenetics, resistance to chemotherapy, and poor, short-term, survival. International Scientific Literature, Inc. 2020-03-10 /pmc/articles/PMC7081950/ /pubmed/32152261 http://dx.doi.org/10.12659/AJCR.920489 Text en © Am J Case Rep, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Elsabah, Hesham
Soliman, Dina S.
Ibrahim, Feryal
Al-Sabbagh, Ahmad
Yassin, Mohamed
Moustafa, Abbas
Nashwan, Abdulqadir M.
Nawaz, Zafar
ElOmri, Halima M.
Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature
title Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature
title_full Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature
title_fullStr Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature
title_full_unstemmed Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature
title_short Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature
title_sort plasma cell myeloma with an aggressive clinical course and anaplastic morphology in a 22-year-old patient: a case report and review of literature
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081950/
https://www.ncbi.nlm.nih.gov/pubmed/32152261
http://dx.doi.org/10.12659/AJCR.920489
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