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"Flaming" Plasma Cells in a 28-Year-Old Man with Non-Secretory Multiple Myeloma by Jinge Bao, Guiying Li, Jing Zhang, Jing Xu, Huifen Zuo

Background: Plasma cell myeloma is almost never detected in children and very rarely in adults aged less than 30 years. It is suggested by some authorities that almost all cases of multiple myeloma, in which “flaming” plasma cell infiltration is in the bone marrow, are IgA myeloma.
Methods: Herein, for the first time we report a case of non-secretory multiple myeloma in a 28-year-old man, whose bone marrow smears showed significantly increased peculiar abnormal plasma cells of the “flaming type”.
Results: Given that the BM aspirate suggested typical multiple myeloma-like morphological features and antigen expression, the diagnosis of non-secretory multiple myeloma was made based on a combination of the clinical symptoms, morphology, flow cytometry immunophenotyping, immunofixation electrophoresis, and bone marrow biopsy. Overall, the result accorded with non-secretory multiple myeloma based on the WHO classification.
Conclusions: We present the case given its rarity and occasional misdiagnosis. It is vital for doctors and the lab staff to distinguish it from reactive plasmacytosis. Besides IgA type multiple myeloma, "Flaming" type plasma cells in large numbers may also be present in non-secretory multiple myeloma.

DOI: 10.7754/Clin.Lab.2021.210916