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Case Reports in Hematology
Volume 2013, Article ID 293150, 5 pages
http://dx.doi.org/10.1155/2013/293150
Case Report

Biclonal IgD and IgM Plasma Cell Myeloma: A Report of Two Cases and a Literature Review

1Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada M5S 1A1
2Pathology Laboratory, Patras General Hospital “O Agios Andreas,” 26500 Patras, Greece
3Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15261, USA
4The Institute for Transfusion Medicine, Pittsburgh, PA 15213, USA
5Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599-7525, USA

Received 16 August 2013; Accepted 17 September 2013

Academic Editors: R. Herrmann, K. Konstantopoulos, A. Ohsaka, and T. Sonoki

Copyright © 2013 Zhongchuan W. Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Biclonal plasma cell myelomas producing two different isotypes of immunoglobulins are extremely rare entities; to date, the combination of IgD and IgM secretion by a biclonal plasma cell myeloma has not been reported. Bone marrow biopsy immunohistochemical studies in two cases revealed neoplastic plasma cells coexpressing IgD and IgM, but serum protein electrophoresis identified only the IgM monoclonal paraprotein in both cases. Biclonal plasma cell myelomas, while currently not well characterized in terms of their clinical behavior, should be distinguished from B-cell lymphoma with plasmacytic differentiation, given the different therapeutic implications. Both cases reported herein demonstrated chemotherapy-resistant clinical courses.