The neoplastic cells in most cases of multiple myeloma closely resemble normal
plasma cells. Recent reports emphasized that the neoplastic plasma cells with atypical
morphology such as, multinucleated, multilobated, cleaved and monocytoid nuclear
feature, are closely associated with aggressive disease progression and poor prognosis.
We experienced a case of multiple myeloma in which the neoplastic plasma cells have
cleaved, multilobated and monocytoid nuclei. Although initial laboratory findings are
within normal limit, patient had developed acute - onset paraplegia and had emergency
operation. In bone biopsy, neoplastic plasma cells are infiltrated in the regional muscle
and the fatty tissue. In spite of operation, radiation therapy, and chemotherapy patient
had aggressive clinical course and expired at hospital day 108.
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