Atypical multicentric reticulohistiocytosis with paraproteinemia

Abstract

Two women had multiple subcutaneous nodules that showed features of multicentric reticulohistiocytosis (MR). Neither had joint symptoms. Both had a raised erythrocyte sedimentation rate, an immunoglobulin G paraproteinemia and raised levels of nonhepatic serum alkaline phosphatase. The skin lesions were followed up, using light microscopy and EM immunoperoxidase and histochemical methods. The material in the giant cells stained positively for .gamma. H chain determinants: the L chain type in each case was that of the paraprotein. An attempt to reproduce the skin lesions in 1 patient by intradermal injection of her paraprotein failed.