Case Report

Plasma Cell Leukemia Presenting as Organizing Pneumonia Refractory to High-Dose Steroid Therapy

Authors: Nishant Tageja, MD, Jasdeepa Nagi, MD, Jason Valent, MD, Jeffrey Zonder, MD

Abstract

A case of steroid-refractory organizing pneumonia (OP) as the initial presentation of plasma cell leukemia (PCL) in a patient who had no prior exposure to chemotherapy or radiation is described. Since OP is traditionally a steroid-responsive disease, this case raises the possibility of a previously unknown patient subgroup with variable disease pattern and/or behavior in patients with plasma cell neoplasm.


Key Points


* Plasma cell leukemia joins the short list of hematologic malignancies that have been directly associated with organizing pneumonia (OP).


* Respiratory failure caused by OP can precede the diagnosis of a malignancy.


* The possibility of a steroid-refractory variant of OP in patients with hematologic malignancies, especially plasma cell leukemia, cannot be denied.

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