CAJ | 학술논문

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,λ链正常；尿免疫球蛋白K链3.8mg/dl,λ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.
환자남,41세.우둔부침윤성반괴3개월여,반통양.피부과검사:우둔부가견약계단대소홍갈색침윤성반괴,주변산재대소불등경도침윤성암홍반.피손조직병리검사:염증세포미만성침윤심체지방층,정단괴혹편상,침윤적세포이장세포위주,간잡림파세포、조직세포,장세포교성숙、핵사분렬상미견.항산염색(-),PAS(-).면역조화검사:CD138(+),κ(+),λ(+).실험실검사:혈청면역구단백κ련1570.00mg/dl,λ련정상；뇨면역구단백K련3.8mg/dl,λ련정상；뇨액본주단백(-)；혈청단백전영:γ구단백24.60.골수활검미견명현이상.진단:피부장세포증다증.환자경수술절제급곡안서룡、사리도알치료후,피손침윤감경,면적축소.
The patient was a 41-year-old man,who presented with painful,pruritie 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 immunoglobulin λ chain was normal in both sera and urine.Urinary Bence-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.