Abstract
Plasma cell leukemia is a rare disease entity where the number of clonal plasma cells in the peripheral blood exceeds 2X109/l or 20% of the total leukocyte count. This plasma cell leukemia can be primary which is arising denovo or secondary as in the course of plasma cell myeloma. A 48 years old male patient came to the emergency outpatient department with complaints of acute renal failure without any prior history of diabetes or hypertension. On examination patient also had hepatosplenomegaly. Peripheral smear showed 56% plasmacytoid cells. Bone marrow aspirate and biopsy revealed a hyper cellular marrow. Marrow showed chiefly plasmablasts (32%) with plenty of abnormal plamacytoid cells (21%). Other marrow elements were grossly reduced. This case is presented because of its rarity, presenting at a younger age, primary type of plasma cell leukemia, presence of organomegaly and unique morphology of the cells in the blood and bone marrow.