Plasma Cell Dyscrasia Masquerading Acute Leukemia: A Diagnostic Challenge

Introduction: Increase in bone marrow plasma cells can be seen in many conditions including reactive as well as neoplastic. High marrow plasma cell count can present a diagnostic dilemma. Case report: We present a case of acute T-cell lymphoblastic leukemia initially presenting as bone marrow plasmacytosis (60%) and reported as plasma cell dyscrasia on morphology on bone marrow aspiration. Reason for reactive plasmacytosis may be due to release of paracrine growth factor especially interleukin (IL-6) from the leukemic cells. Conclusion: We reported this case to highlight that transient plasmacytosis can be present in hematological malignancies and therefore, proper workup should be done to avoid the diagnosis of plasma cell dyscrasisas, which can predispose the patient to wrong treatment and hamper/ delay the treatment required.