A 62-year-old woman had multiple plasmacytomas in the skin and lymph nodes, without Bence-Jones protein or a monoclonal peak of serum immunoglobulins. Infiltrating plasmacytoid cells expressed cytoplasmic IgG (lambda) and surface CD38, without any B-cell markers. There was no visceral or bone marrow involvement suggestive of multiple myeloma. Southern blot analysis of extracted DNA from the cutaneous lesions showed two rearranged bands with an immunoglobulin, but not a T-cell receptor, gene probe. The patient showed a poor response to chemotherapy, and died of bronchopneumonia. The clinical course and cytological features differentiate multiple cutaneous extramedullary plasmacytomas from solitary cutaneous extramedullary plasmacytoma and cutaneous lesions associated with multiple myeloma.

1. Wilson E: Lectures on cutaneous medicine and diseases of the skin: X. On ekzema. J Cutan Med 1869;3:105-120. 2. Wilson E: Lectures on cutaneous medicine and diseases of the skin: XII. Leichen, impetigo, scabies. J Cutan Med 1869;3:329\x=req-\ 335. 3. Tegner E: Solitary lichen planus simulating malignant lesions. Acta Derm Venereol 1979;59:263-266. 4. Lumpkin RL, Helwig EB: Solitary lichen planus. Arch Dermatol 1966;93:54-56. 5. Fellner MJ: Lichen planus.

Cutaneous malignant lymphomas developed in an 80-year-old man without any evidence of leukemic disseminations of lymphoma cells. Immunohistologic staining showed the expression of Leu-3a, Leu-4, Ki-1, Tac, and HLA-DR antigens on tumor cells in tissue and large lymphoid cells in long-term, interleukin 2-containing culture of tumor explants. DNA samples extracted from the skin tumors and cultured lymphoid cells showed a clonal rearrangement of T-cell receptor (TCR) gene C beta 1 with the molecular size of 9 kilobases. These findings suggested the T-cell origin of Ki-1+ cutaneous lymphoma cells and the occurrence of a clonal proliferation of tumor cells in culture.

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