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Correspondence |

Monoclonal Gammopathy of Undetermined Significance and Incidentally Identified Cutaneous Monotypic Plasma Cell Infiltrates in the Absence of Specific Skin Lesions

Michael Murphy, MD; Arni Kristjansson, MD; Zendee Elaba, MD; Diana Rozenski, BS
Arch Dermatol. 2010;146(2):204-206. doi:10.1001/archdermatol.2009.387.
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The present case highlights the nosologic complexity of monoclonal gammopathy (MG) associated with monotypic plasma cellular infiltrates in the absence of specific clinical skin lesions or systemic involvement.

Rongioletti  FPatterson  JWRebora  A The histological and pathogenetic spectrum of cutaneous disease in monoclonal gammopathies. J Cutan Pathol 2008;35 (8) 705- 721
PubMed Link to Article[[XSLOpenURL/10.1111/cup.2008.35.issue-8]]
Swerdlow  SHedCampo  EedHarris  NLed  et al.  WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues.  Geneva, Switzerland WHO Press2008;200- 202
Asatiani  ECohen  POzdemirli  MKessler  CMMavromatis  BCheson  BD Monoclonal gammopathy in extranodal marginal zone lymphoma (ENMZL) correlates with advanced disease and bone marrow involvement. Am J Hematol 2004;77 (2) 144- 146
PubMed Link to Article[[XSLOpenURL/10.1002/(ISSN)1096-8652]]
Bayer-Garner  IBPrieto  VGSmoller  BR Detection of clonality with kappa and lambda immunohistochemical analysis in cutaneous plasmacytomas. Arch Pathol Lab Med 2004;128 (6) 645- 648
PubMed
Fitzhugh  VASiegel  DBhattacharyya  PK Multiple primary cutaneous plasmacytomas. J Clin Pathol 2008;61 (6) 782- 783
PubMed Link to Article[[XSLOpenURL/10.1136/jcp.2008.056051]]
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Histopathologic, immunohistochemical, and polymerase chain reaction (PCR) findings and electrophoresis densitometric tracing. A and B, Basal cell carcinoma reexcision specimens showing a dermal and subcutaneous perivascular and interstitial predominantly mature plasma cell infiltrate (hematoxylin-eosin, original magnifications ×40 and ×200, respectively). By immunohistochemical analysis, a kappa (C) to lambda (D) ratio higher than 10:1 is indicative of light chain restriction (original magnification ×200). E, Monoclonal IgH receptor gene rearrangement is detected in the skin by PCR (bp indicates base pair; M, marker; P, patient; −, negative control; and +, positive control). F, Serum protein electrophoresis with densitometric tracing showing the presence of an M protein with a characteristic spike in the γ-globulin region.

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