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Kirk D. Wuepper, MD; Malcolm R. MacKenzie, MD

Arch Dermatol. 1969;100(2):155-164.

Abstract
Extraosseous tumours of the skin were observed in three patients with multiple myeloma. Routine histopathologic study of paraffin-embedded specimens from these tumors suggested the diagnosis of lymphoma or reticulum-cell sarcoma. The cutaneous myeloma cells stained in a characteristic fashion with methyl green-pyronin and touch imprints of the tumors stained with Wright's stain demonstrated, however, typical myeloma cells.

The myeloma serum proteins from two patients were characterized as IgG-L and BJP-K, respectively. These immunoglobulins or immunoglobulin fragments were not demonstrated in the cutaneous metastases by direct fluorescent staining. Touch imprints from one tumor revealed positive cytoplasmic staining for IgM-K and IgM-L in medium-sized lymphocytes, but not in tumor cells. In cryostat-sectioned specimens from this tumor, these fluorescent cells appeared to buttress the tumor masses in the skin. The possibility that these cells may reflect a host mechanism for rejecting tumor cells is suggested.

Author Affiliations
San Francisco

From the Division of Dermatology and the Section of Hematology and Immunology, the Department of Medicine, University of California School of Medicine, San Francisco. Dr. Wuepper is currently at the Department of Experimental Pathology, Scripps Clinic and Research Foundation, La Jolla, Calif. Dr. MacKenzie is currently at the Department of Internal Medicine, the University of Cincinnati College of Medicine, Cincinnati.

Footnotes
Accepted for publication Dec 7, 1968.

Reprint requests to Department of Internal Medicine, the University of Cincinnati College of Medicine, Cincinnati 45229 (Dr. MacKenzie).

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