浆细胞白血病是一种罕见的浆细胞恶液质，预后极差。该病在男性中更为常见，通常发病年龄在 55 至 65 岁之间。一名 34 岁男性因持续背部疼痛到阿萨德医院就诊。他接受了镇痛药，但治疗对疼痛没有反应，并且由于 COVID-19 大流行，他拒绝在医院接受计算机断层扫描。同年晚些时候，他再次出现体重减轻、恶心、腹痛、黑便和腹水的症状。他脸色苍白，腹部适度膨胀。实验室检查显示贫血、血小板减少、高钙血症、总蛋白增加和乳酸脱氢酶升高。骨髓抽吸物的流式细胞术结果显示存在 30% 的浆细胞，CD38、CD56 和 kappa 轻链呈阳性。他被诊断出患有继发性浆细胞白血病并开始接受化疗；然而，由于骨髓抑制，他无法继续治疗。 5个月后去世。由于患者年龄较小，并未怀疑患有多发性骨髓瘤。由于 COVID-19 大流行，诊断被进一步推迟。他的多发性骨髓瘤进展为继发性浆细胞白血病，并具有小肠息肉等罕见特征。尽管化疗取得了突破性的进展，浆细胞白血病仍然具有致命的预后。本报告展示了继发性浆细胞白血病的罕见年龄表现和独特表现。尽管年龄不典型，但对于不明原因的背痛病例，多发性骨髓瘤应作为鉴别诊断。版权所有 © 2023 作者。由 Wolters Kluwer Health, Inc. 出版

Plasma cell leukaemia is an uncommon plasma cell dyscrasia with a very poor prognosis. It is more common among males and usually presents between 55 and 65 years of age.A 34-year-old male presented to Al-Assad hospital with unremitting back pain. He was given analgesics but his pain was unresponsive to treatment, and due to the COVID-19 pandemic, he refused a computed tomography scan in the hospital. Later that year, he presented again with weight loss, nausea, abdominal pain, melena, and ascites. He was pale with a moderately distended abdomen. Laboratory tests revealed anaemia, thrombocytopenia, hypercalcemia, increased total proteins, and elevated lactate dehydrogenase. Flow cytometry findings of the bone marrow aspirate showed the presence of 30% of plasma cells, positive for CD38, CD56, and kappa light chains. He was diagnosed with secondary plasma cell leukaemia and started on chemotherapy; however, he could not continue his treatment due to myeloid inhibition. He passed away 5 months later.Multiple myeloma was not suspected in the patient due to his young age. The diagnosis was delayed even further due to the COVID-19 pandemic. His multiple myeloma progressed into secondary plasma cell leukaemia and had uncommon features like small intestinal polyps. Even though there has been groundbreaking advancements in chemotherapy, plasma cell leukaemia still possesses a fatal prognosis.This report showcases a rare age presentation with unique manifestations of secondary plasma cell leukaemia. Multiple myeloma should be a differential diagnosis for cases with unexplained back pain despite an unclassical age.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.