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Case Reports in Hematology
Volume 2017, Article ID 8152610, 4 pages
https://doi.org/10.1155/2017/8152610
Case Report

Cutaneous Vasculitis: An Unusual Presentation of a Biclonal Nodal Plasma Cell Dyscrasia

1Haematology Department, University Hospital Waterford, Regional Cancer Center South East, University College Cork, Cork, Ireland
2Pathology Department, University Hospital Waterford, Regional Cancer Center South East, University College Cork, Cork, Ireland

Correspondence should be addressed to D. Swan; moc.liamg@321nawsnwad

Received 27 June 2017; Accepted 31 July 2017; Published 13 September 2017

Academic Editor: Marie-Christine Kyrtsonis

Copyright © 2017 D. Swan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe an unusual case of a biclonal nodal plasma cell dyscrasia, presenting with a vasculitic rash, end-organ damage, and cytopenias. Serum protein electrophoresis demonstrated a biclonal kappa-restricted paraprotein, with a negative skeletal survey and no bone marrow disease. Fluorodeoxyglucose-PET-CT (FDG-PET-CT) revealed nodal involvement, which was not appreciable clinically, and facilitated biopsy, confirming the diagnosis of a nodal plasmacytoma. Complete biochemical response and resolution of the vasculitic rash were achieved with bortezomib-based therapy.