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Myeloma cells are notorious for their morphological variations, which range from mature-appearing plasma cells to other poorly differentiated forms. The pleomorphic or anaplastic variants are its uncommon rare variants, which may pose a diagnostic dilemma in unprecedented cases. These anaplastic variants may mimic high-grade lymphomas, leukemia, or even metastatic carcinomas [1,2]. Anaplastic plasma cells may be seen at diagnosis or evolve during the terminal phase of the disease [3]. The correlation of this morphological variant with treatment outcome is controversial, but it is believed to be a harbinger of aggressive disease [4,5]. Herein we report the case of an unsuspected multiple myeloma, where bone marrow examination revealed the presence of bizarre plasma cells simulating megakaryocytes.

Pleomorphic Multinucleated Plasma Cells Simulating Megakaryocytes in an Anaplastic Variant of Myeloma