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Case Report

Rapidly enlarging cutaneous nodules on a full-thickness skin graft following an excision of a squamous cell carcinoma – a diagnostic clue for multiple myeloma

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Pages 17-19 | Received 15 Jul 2014, Accepted 30 Oct 2014, Published online: 24 Nov 2014

Figures & data

Figure 1. (a) Cutaneous dome shaped nodules peripherally located on the full thickness skin graft, three weeks after excision of squamous cell carcinoma (b) 7 days later, rapid growth and ulceration of the lesions expanding beyond the graft site.

Figure 1. (a) Cutaneous dome shaped nodules peripherally located on the full thickness skin graft, three weeks after excision of squamous cell carcinoma (b) 7 days later, rapid growth and ulceration of the lesions expanding beyond the graft site.

Figure 2. (a) Immature plasma cells, with large eccentric nuclei and scattered mitosis (H&E ×40). (b) Intense staining of CD138 (×10). (c) Positive staining for Ki67 (high proliferation index >80%) (×10).

Figure 2. (a) Immature plasma cells, with large eccentric nuclei and scattered mitosis (H&E ×40). (b) Intense staining of CD138 (×10). (c) Positive staining for Ki67 (high proliferation index >80%) (×10).

Figure 3. Computed tomography showing destruction of the proximal humerus by a large osteolytic lesion. There is soft tissue plasmacytoma located on the anterior chest wall and partial destruction of the sternum.

Figure 3. Computed tomography showing destruction of the proximal humerus by a large osteolytic lesion. There is soft tissue plasmacytoma located on the anterior chest wall and partial destruction of the sternum.

Figure 4. (a) Tumour cells expressing surface IgA. (×40) (b & c) Kappa and lambda light chains, (c) plasma cells showing restriction of immunoglobulin lambda-chain expression (×10).

Figure 4. (a) Tumour cells expressing surface IgA. (×40) (b & c) Kappa and lambda light chains, (c) plasma cells showing restriction of immunoglobulin lambda-chain expression (×10).