Clinical Features

Elderly or middle-aged persons (mean age approximately 60 years; range from 22 to 88 years) are mainly affected. There is a prominent male preponderance (male:female ratio, 4:1) (2). PCP manifests as solitary or multiple (up to 50), asymptomatic, red-purple nodules or plaques with no predilection site (Fig. 1). Ulceration is rarely observed (3,4).

Figure 1 Solitary well-circumscribed nodule on the back.

Primary Cutaneous Plasmacytoma (PCP) HISTOLOGY

There is a diffuse or nodular infiltrate (Fig. 2) composed of plasma cells with varying degrees of maturation and pleomorphism. The infiltrate usually spares the epidermis and often shows perivascular and/or periadnexal accentuation. The subcutis may be involved. Sometimes the tumor consists almost exclusively of mature-looking plasma cells with a "clock-face" nuclear chromatin pattern (Fig. 3). In other cases, there are high numbers of pleomorphic and immature cells (plasmablasts). The latter have dispersed chromatin, a high nuclear/cytoplasmic ratio, and prominent nucleoli. A typical finding is the presence of Russell and Dutcher bodies (intracytoplasmic and intranuclear inclusions respectively). Multinucleated plasma cells as well as mitotic figures can be found (3,5,6).

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