t(11;14) Plasma cell disorder presents as a true nonsecretory, nonproducer multiple myeloma.

We describe an extremely rare case of so-called nonsecretory, nonproducer myeloma in an 80-year-old man who presented with weight loss and anemia. The patient's serum protein electrophoresis was negative for M protein spike, and quantitation of his immunoglobulin level was far below the normal range. The bone marrow biopsy showed a sheet-like diffuse plasmacytic infiltrate with essential absence of trilineage hematopoiesis. Flow cytometry analysis and immunohistochemical study demonstrated a strong CD38/CD138/immunoglobulin G heavy chain-positive plasma cell population but failed to detect either cytoplasmic kappa or lambda light chain expression. Chromosomal analysis and dual fluorescence in situ hybridization studies clearly demonstrated the presence of t(11;14)(q13;q32) translocation in the neoplastic plasma cells.