HistoryThis section has been translated automatically.
Mac Intyre, 1850; Kahler, 1889
DefinitionThis section has been translated automatically.
Plasmocytoma is the solitary organ manifestation of "multiple myeloma". Plasmocytomas of the skin are very rare. They can occur as:
- Primary cutaneous (extramedullary) B-cell NHL with a low degree of malignancy (see below Primary cutaneous B-cell lymphomas) without (primary detectable) systemic involvement.
- Secondary (metastatic) manifestations of multiple myeloma (these are somewhat more common). In this case, they would be referred to as cutaneous organ manifestations of multiple myeloma . Metastatic cutaneous infiltrations (see also leukemia cutis) usually occur in scarred structures (e.g., sternotomy scars; Li A et al. ). They are associated with a significantly worse prognosis than primary cutaneous plasmacytomas(Yoo J et al.).
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EtiopathogenesisThis section has been translated automatically.
Unknown; extramedullary plasmocytomas are frequently found after organ transplants. Individual reports exist about an EBV association.
ManifestationThis section has been translated automatically.
The average age is 70 years
LocalizationThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
HistologyThis section has been translated automatically.
Nodular or diffuse tumour cell aggregates in the entire dermis and possibly in subcutaneous fatty tissue. Mostly atypical plasmacytoid cells, mature or immature plasma cells; more rarely immunoblasts. No epidermotropy. Intracellular: immunoglobulins, often monoclonal IgA synthesis and more rarely IgG synthesis. In PAS preparations, PAS-positive inclusions in the cytoplasm (Russel corpuscles).
DiagnosisThis section has been translated automatically.
Histological and immunohistological clarification of the findings is important, as well as the exclusion of systemic involvement (extremely accelerated BSG, 1-h value:>100mm n.W., so-called fall reduction, proteinuria with L-chain excretion = (Bence-Jones proteins; Bence-Jones proteins are found in about 60% of all multiple myelomas from IgG or IgA light-chain myeloma). Low-dose CT is recommended as the most sensitive imaging method. Skeletal scintigraphy is less suitable because myeloma foci often do not store data. MRI and PET are suitable for extramedullary foci.
Differential diagnosisThis section has been translated automatically.
Note(s)This section has been translated automatically.
The term plasmacytoma is only valid for solitary monorganic involvement of an organ, in the absence of bone marrow infiltration.
Low-malignant B-cell NHL, as a systemic disease with mostly multilocular or diffuse infiltration of the bone marrow by malignant cloned plasma cells, is referred to as"multiple myeloma" (C90.00).
Only in case of systemic involvement (multiple myeloma) the following parameters become diagnostically relevant: massive elevation of ESR, paraproteinemia, paraproteinuria (Bence-Jones sample), also cryoglobulins. X-ray skull: moth-eaten osteolysis (note: myeloma cells have no osteolytic activity of their own; however, they stimulate osteolysis via various cytokines (RANKL). (Note: Myeloma cells have no osteolytic activity of their own; however, they stimulate osteoclast activity via various cytokines (RANKL =receptor activator of NF-kB ligand, MIP-1= macrophage inflammatory protein = CCL3) and at the same time inhibit osteoblast activity.
LiteratureThis section has been translated automatically.
- Bayer-Garner IB et al (2003) The spectrum of cutaneous disease in multiple myeloma. J Am Acad Dermatol 48: 497-507
- Cerroni L, Kerl H (2003) Cutaneous B-cell lymphomas. In: Kerl H et al (eds) Histopathology of the skin. Springer Verlag, Berlin Heidelberg New York pp. 908-910.
- Gómez-Armayones S et al (2015 Cutaneous nodules in multiple myeloma. Cutaneous plasmacytoma associated with multiple myeloma. ActasDermosifiliogr
- Kahler O (1889) On the symptomatology of multiple myeloma. Observation of albumosuria. Prager medicinische Wochenschrift (Prague) 14: 33-35 u. 44-49
- Kazakov DV (2002) Primary cutaneous plasmacytoma: a clinicopathological study of two cases with a long-term follow-up and review of the literature. J Cutan Pathol 29: 244-248
- Landthaler M, Scherer R, Wolff HH (1980) Cryoglobulinemia in plasmacytoma. Dermatologist 31: 661-667
- Li A et al.(2013) Primary cutaneous plasmacytoma occurring after pacemaker implantation andrecurring
in scar tissue. Dermatol Online J 19:3.
- MacIntyre W (1850) Case of mollities and fragilitas ossium. Medico-Chirurgical Transactions (London) 33: 211-232.
- Maejima H et al (2014) Multiple primary cutaneous plasmacytoma. Acta Dermatovenerol Croat 22:308-310
- Santos G et al (2014) Case for diagnosis. Cutaneousinvolvement associated to multiple myeloma. An Bras Dermatol 89:173-174
- Yoo J et al (2017) Cutaneous plasmacytoma: metastasis of multiple myeloma at the fracture site.
Ann Dermatol 29:483-486.
- Wuu A et al (2014) Primary cutaneous plasmacytoma. Cutis.93:E19- 21
Incoming links (7)Beta2-microglobulin; Cd classification; Cutaneous plasmocytoma; CVID; Lichen myxoedematosus (classic type); Multiple myeloma; Primary cutaneous marginal zone lymphoma;
Outgoing links (13)Ccl3; Cd138; CD20; Cd38; Cd45; Cd79a; Leukemia cutis; Multiple myeloma; Paraneoplastic syndromes (overview); Primary cutaneous B-cell lymphomas; ... Show all
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