皮肤浆细胞增多症一例  

A case of cutaneous plasmacytosis

作　　者：白倩倩[1] 汪晨[1] 姚志远[1] 

机构地区：[1]北京中日友好医院皮肤科,100029

出　　处：《国际皮肤性病学杂志》2012年第3期142-143,共2页International Journal of Dermatology and Venereology

摘　　要：患者男，41岁。右臀部浸润性斑块3个月余，伴痛痒。皮肤科检查：右臀部可见约鸡蛋大小红褐色浸润性斑块，周边散在大小不等轻度浸润性暗红斑。皮损组织病理检查：炎症细胞弥漫性浸润深达脂肪层，呈团块或片状，浸润的细胞以浆细胞为主，间杂淋巴细胞、组织细胞，浆细胞较成熟、核丝分裂相未见。抗酸染色（-），PAS（-）。免疫组化检查：CD138（＋），κ（＋），λ（＋）。实验室检查：血清免疫球蛋白κ链1570．00mg／dl，入链正常；尿免疫球蛋白K链3．8mg／dl，入链正常；尿液本周蛋白（-）；血清蛋白电泳：γ球蛋白24．60。骨髓活检未见明显异常。诊断：皮肤浆细胞增多症。患者经手术切除及曲安西龙、沙利度胺治疗后，皮损浸润减轻，面积缩小。The patient was a 41-year-old man, who presented with painful, pruritic and infiltrated plaques in the gluteal region for more than 3 months. Skin examination showed brunneus, egg-sized, infiltrated plaques in the right gluteal region surrounded by irregularly sized, mildly infiltrated and dark erythematous patches. Histopathological examination revealed a diffuse, clump- or patch-like inflammatory cell infiltrate predominated by mature plasma cells mixed with lymphocytes and histiocytes, which extended into the fat tissue. No mitosis was observed. Neither acid-fast nor periodic acid-Schiff （PAS） stain was positive. Immunohistochemistry showed positive staining for CD138, and λ chain. Laboratory examination showed that the concentration of immunoglobulin κ chain was 1570.00 mg/dl in sera and 3.8 mg/dl in urine, while that of immunoglobulinκ chain was normal in both sera and urine. Urinary Benee-Jones protein was negative. Serum protein electrophoresis showed that the level of γ-globulin was 24.60. Bone marrow biopsy showed no abnormality. He was finally diagnosed with cutaneous plasmacytosis. After managed with surgical resection as well as oral triamcinolone and thalidomide, the lesional infiltration and area decreased.

关 键 词：浆细胞 皮肤 细胞增殖 

分 类 号：R733.3[医药卫生—肿瘤]