PMC9467293_01
(A and B) Multiple irregular-shaped, dark-red, soft to fluctuant, well-demarcated, and infiltrated plaques ranging in size from 1 to 8 cm in diameter disseminating on the head.
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Physical examination revealed multiple irregular-shaped, dark-red, soft to fluctuant, well-demarcated plaques on the scalp ranging from 1 to 8 cm in diameter (Figure 1).
(A) Histopathology showed that small lymphocytes of the mantle zones are arranged in concentric rings around the atrophied germinal center, and amounts of plasma cells in the interfollicular region (HE, Ax100). The immunohistochemistry results of CD3 (a, x40), CD20 (b, x40), Ki67 (c, x40), CD38 (d, x40), CD138 (e, x40), Kappa (f, x40), Lambda (g, x40), BCL-2 (h, x40), CD21 (i, x40), CD34 (j, x40), IgG (k, x40), IgG4 (l, x40).
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The immunohistochemistry results are as followed: CD3 (partial +), CD20 (partial +), Ki67 (+), CD38 (+), CD138 (+), Kappa (+), Lambda (+), BCL-2 (perifollicular +), CD21 (dendritic cell+), CD34 (vascular+), IgG (+), IgG4 (+) (Figure 2).
(A and B), (A) showed reactive lymphoid follicular hyperplasia within the dermis. (B) revealed neutrophil and plenty of plasma cells infiltration. (HE, Ax40, Bx200). The immunohistochemistry results of CD3 (a, x40), CD20 (b, x40), CD38 (c, x40), CD138 (d, x40), IgG (e, x40), IgG4 (f, x40), CD34 (g, x40), Kappa (h, x40), Lambda (i, x40), BCL-2 (j, x40) and Ki-67 (k, x40).
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BCL-2, and Ki-67 was performed (Figure 3). Based on the clinical, laboratory, and pathological findings, the patient was diagnosed with the plasmacytic variant of idiopathic multicentric CD (pMCD).