Cutaneous Extramedullary Plasmacytomas

doi:10.1001/archderm.1969.01610260031005

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Vol. 100 No. 2, August 1969

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Cutaneous Extramedullary Plasmacytomas

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 patientswith multiple myeloma. Routine histopathologic study of paraffin-embeddedspecimens from these tumors suggested the diagnosis of lymphomaor reticulum-cell sarcoma. The cutaneous myeloma cells stainedin a characteristic fashion with methyl green-pyronin and touchimprints of the tumors stained with Wright's stain demonstrated,however, typical myeloma cells.

The myeloma serum proteins from two patients were characterizedas IgG-L and BJP-K, respectively. These immunoglobulins or immunoglobulinfragments were not demonstrated in the cutaneous metastasesby direct fluorescent staining. Touch imprints from one tumorrevealed positive cytoplasmic staining for IgM-K and IgM-L inmedium-sized lymphocytes, but not in tumor cells. In cryostat-sectionedspecimens from this tumor, these fluorescent cells appearedto buttress the tumor masses in the skin. The possibility thatthese cells may reflect a host mechanism for rejecting tumorcells 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 Universityof Cincinnati College of Medicine, Cincinnati 45229 (Dr. MacKenzie).

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