Adenopathy and extensive skin patch overlying a plasmacytoma (AESOP): Two morphologic variants can be outlined

A case of relapsed systemic multiple myeloma mimicking adenopathy and extensive skin patch overlying a plasmacytoma

“…4 Most published cases were secondary to monoclonal gammopathy of unknown significance or POEMS syndrome with or without Castleman disease. 5 , 6 The characteristic histopathologic findings of AESOP syndrome are diffuse capillary dilations that can be accompanied by dermal deposition of mucin and a mild inflammatory infiltrate of variable composition. 7 , 8 CD31 immunohistochemical staining can also be positive.…”

“…Both multiple myeloma and AESOP syndrome can be associated with POEMS syndrome. 5 , 8 POEMS syndrome is defined by the presence of both peripheral neuropathy and monoclonal plasma-cell disorder plus 1 major and 1 minor criterion. The 3 major criteria for the diagnosis of POEMS syndrome are osteosclerotic bone lesions, elevated vascular endothelial growth factor levels, and Castleman disease.…”

“…Although both entities can present in association with POEMS syndrome, the main differences are that in AESOP syndrome the plasmacytoma is localized, and the prognosis is more favorable. 4 , 5 , 8 …”

Cutaneous manifestations of monoclonal gammopathy

“…4 ). An erythematous patch overlying a solitary bone plasmacytoma and associated with local adenopathy (AESOP syndrome) has also been described [ 61 ]. Histopathological studies demonstrate clonal infiltration by plasma cells [ 51 , 62 , 63 ].…”