J Korean Med Sci.  2005 Jun;20(3):506-508. 10.3346/jkms.2005.20.3.506.

A Case of Reactive Plasmacytosis Mimicking Multiple Myeloma in A Patient with Primary Sjogren's Syndrome

• Lee J
• Chang JE
• Cho YJ
• Han WS

• KMID: 1778516
• DOI: http://doi.org/10.3346/jkms.2005.20.3.506

Abstract

Primary Sjogren's syndrome (pSS) is a chronic autoimmune disease with welldocumented association of lymphoid malignancies during the progress of the disease. Although several types of malignancy and pseudomalignancy have been reported in pSS, low-grade non-Hodgkin's lymphomas are the most frequently observed. Reactive plasmacytosis mimicking myeloma is a very rare condition in association with pSS. We describe a 72-yr-old woman with pSS who presented with hypergammaglobulinemia, and extensive bone marrow and lymph node plasmacytosis, which mimicked multiple myeloma. In this patient, there was an abnormal differentiation of memory B cells to plasma cells in the peripheral blood suggesting underlying pathogenetic mechanism for this condition.

Keyword

Sjogren's Syndrome; Plasma Cells; Plasmacytosis; B Cell Differentiation

MeSH Terms

Aged
Antigens, CD19/analysis
Antigens, CD27/analysis
Bone Marrow Examination
Diagnosis, Differential
Female
Fluorescent Antibody Technique/methods
Humans
Multiple Myeloma/*pathology
Plasma Cells/chemistry/*pathology
Sjogren's Syndrome/*pathology

Figure

• 

  Fig. 1 Bone marrow biopsy (A) and lymph node biopsy (B) specimens. BM biopsy revealed normocellular marrow with multifocal increase of plasma cells. Lymph node biopsy shows profound germinal center reaction with infiltration of plasma cells (H&E stain, ×400).

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  Fig. 2 Immunofluorescence staining of CD27 on CD19+ peripheral blood B cells at baseline (A) and 3 months after treatment (B). At baseline, there was marked increase of CD19+/CD27high plasma cells and significant reduction of CD19+/CD27+ memory B cells. After treatment, reduction of mermory B cells with abnormal plasmacytosis was no longer observed. P, plasma cell; M, memory B cell; N, naive B cell.

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