Horiguchi Y, Takahashi C, Imamura S
Department of Dermatology, Faculty of Medicine, Kyoto University, Japan.
Am J Dermatopathol. 1993 Feb;15(1):59-63. doi: 10.1097/00000372-199302000-00011.
We report a solitary nodular form of primary cutaneous amyloidosis due to locally infiltrating plasma cells. An 81-year-old Japanese women presented with a scarlet, dome-shaped 1.5-cm nodule with an irregular surface. Histology showed thick deposits of eosinophilic, oval, and homogeneous bodies in the dermis with mild infiltrates of mononuclear cells. The homogeneous bodies stained positively with periodic acid-Schiff, Congo red, and Yanagihara's Dylon stain, and immunohistochemically with anti-human lambda light-chain antibody. Methylgreen pyronine staining revealed that approximately half of the cellular infiltrates around the vessels were plasma cells. Electron microscopy demonstrated the homogeneous bodies to be amyloid masses, a part of which were in the cytoplasm of the plasma cells. Laboratory examination showed a slight elevation of IgG but no obvious findings suspicious for systemic amyloidosis or gammopathy.
我们报告了一例因局部浸润浆细胞导致的孤立结节型原发性皮肤淀粉样变。一名81岁的日本女性，出现一个表面不规则的1.5厘米猩红色圆顶状结节。组织学检查显示真皮内有嗜酸性、椭圆形且均质的物质厚层沉积，伴有轻度单核细胞浸润。这些均质物质经高碘酸 - 希夫染色、刚果红染色和柳原氏迪隆染色呈阳性，免疫组化检查显示抗人λ轻链抗体染色阳性。甲基绿派洛宁染色显示血管周围约一半的细胞浸润为浆细胞。电子显微镜检查证实这些均质物质为淀粉样物质团块，其中一部分存在于浆细胞的细胞质中。实验室检查显示IgG略有升高，但无明显提示系统性淀粉样变或丙种球蛋白病的可疑发现。
