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Peripheral blood plasmacytosis in a patient with infectious mononucleosis‐like illness

To the editor: Plasmacytosis is rarely seen in the peripheral blood, except in plasma-cell leukaemia. We encountered a patient with transient massive plasmacytosis of the peripheral blood concomitant with heterophil antibody-negative infectious mononucleosis-like illness. A 35-year-old female was admitted for an operation with the diagnosis of cholecystolithiasis. She showed no abnormality in preoperative examination, and the cholecystectomy was done on February 5, 1990. On February 10, she complained of malaise, high fever and sore throat. Physical examination disclosed multiple cervical lymphadenopathy with tenderness, erosive pharyngeal redness with swelling and mild hepatomegaly. Blood chemistry showed mild liver cell dysfunction and peripheral blood examination revealed a haemoglobin level of 108 g/l, a hematocrit of 33.1%, a platelet count of 152 x 109/1, and a white blood cell count of 10.1 x 10y/l with a differential of 9.0% bands, 27.0% segmented neutrophils, 10.0% eosinophils, 2.0% monocytes, 14.0% lymphocytes, and 38.0% atypical lymphocytes. The majority of atypical lymphocytes had abundant granular endoplasmic reticulum and Golgi zone, which are characteristic structures for the plasma cell by electron microscopic