A 56-year-old man was diagnosed with a primary plasma cell leukemia. Despite several chemotherapy treatments the patient died 6 months from diagnosis with resistant disease. Bone marrow aspirate revealed an increased number of atypical plasma cells, some with phagocytosis of erythrocytes (arrows). Phagocytosis of blood cells by plasma cells is a rare phenomenon which has been reported in multiple myeloma, monoclonal gammopathy of undetermined significance and plasma cell leukemia.