Cutaneous plasmacytosis pathology

Author: Adjunct A/Prof Patrick Emanuel, Dermatopathologist, Clinica Ricardo Palma, Lima, Peru. DermNet NZ Editor-in-chief: Adjunct A/Prof Amanda Oakley. July 2018. 


Introduction

Cutaneous plasmacytosis presents with multiple reddish brown nodules. It has most often been reported to affect the trunk but is also known to affect the face and extremities in adults and is predominantly seen in Asians. The aetiology is poorly understood. It is also known as benign lymphoplasmacytic plaque.

Histology of cutaneous plasmacytosis

In cutaneous plasmacytosis, histopathological examination shows perivascular and perineural plasma cell infiltrates in the dermis (figures 1-4) without evidence of folliculitis or other common caused of plasma cell infiltrates (figures 1-4)

Cutaneous plasmocytosis pathology

Special studies for cutaneous plasmacytosis

It is important to demonstrate that the plasma cells are polyclonal. This can be done with kappa and lambda immunohistochemistry or in situ hybridisation. 

Differential diagnosis for cutaneous plasmacytosis

Other diagnoses to be considered include:

  • Infection — Some infections cause dense plasma cell infiltrates (eg, syphilis, Lyme disease). Special stains, culture or more sophisticated investigations are important to rule out an atypical infection
  • Lymphoma/plasmacytoma — Clonality studies (kappa/lambda stains or gene rearrangement studies) may be needed to exclude a plasma cell-rich lymphoma.

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Related information

 

References

  • Han XD, Lee SSJ, Tan SH, Chong WS, Ng SK, Ooi MGM, Goh CL. Cutaneous Plasmacytosis: A Clinicopathologic Study of a Series of Cases and Their Treatment Outcomes. Am J Dermatopathol. 2018 Jan;40(1):36-42. doi: 10.1097/DAD.0000000000000907. PubMed PMID: 28475511. PubMed.

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