Etiological Profile of Plasmacytosis on Bone Marrow Aspirates

• Main Authors: Monika Gupta, Shivani Malik, Rajnish Kalra, Nisha Sharma, Sunita Singh, Veena Gupta, Promil Jain, Rajeev Sen
• Format: Article
• Language: English
• Published: Dicle University Medical School 2016-03-01
• Series: Dicle Medical Journal
• Subjects: Reactive plasmacytosis; bone marrow; mul­tiple myeloma
• Online Access: http://www.diclemedj.org/upload/sayi/59/Dicle%20Med%20J-02409.pdf

Objective: In recent years, during routine examination of bone marrow aspirates, an increased plasma cell per­centage has been noted in a good number of cases which included both neoplastic and non-neoplastic diseases. An attempt has been made to observe the spectra of condi­tions with plasmacytosis in bone marrow. Methods: The present study was conducted in the de­partment of pathology over a period of one year. A total of 114 bone marrow aspirates that showed increased plas­ma cells (>3.5%) constitute the study material. A detailed relevant clinical examination followed by complete blood count, peripheral smear examination and bone marrow aspiration was done in all cases. Results: There was slight female predominance with male to female ratio of 1:1.1. The majority of patients were in 4th decade. The plasma cell concentration ranged from 5% to 36%. As far as the etiology is concerned, 96 cases (84.2%) were non-neoplastic and 18 cases (15.7%) had neoplastic etiology. Conclusion: Bone marrow plasmacytosis can present as diagnostic dilemma and some time can be challenging to differentiate reactive from neoplastic condition as there is an overlap both in counts and morphology. Each case with plasmacytosis especially in the overlap range requires complete clinical evaluation, individualized investigations and more specific tests like immunoelectrophoresis and bone marrow biopsy with immunohistochemistry to arrive at a final diagnosis for patient management.