AN UNUSUAL PRESENTATION OF PRIMARY PLASMA CELL LEUKEMIA AS A PSYCHIATRIC DISORDER: A DIAGNOSTIC DILEMMA- A CASE REPORT AND REVIEW OF LITERATURE

Plasma cell leukemia (PCL) is a rare disorder that can develop spontaneously (primary) or evolve in patients with multiple myeloma (secondary). Histogenetically, plasma cell leukemia is derived from terminally differentiated B cells. It is diagnosed by the presence of absolute plasma cell count >2000/cumm or >20% circulating plasma cells in blood. We report a rare case of primary plasma cell leukemia in patient with unique presentation of a psychiatric illness having hallucinations, mood changes and loss of insight. The patient had past history of pulmonary tuberculosis and developed de novo PCL as there was no previous history of multiple myeloma. Clinical spectrum, cytomorphological features and prognosis of PCL are also discussed in this case report.