Case Report Mixed Phenotype Acute Leukemia Presenting as Leukemia Cutis (original) (raw)
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MOH Journal of Medical Case Reports, 2024
Acute myeloid leukemia (AML) can initially present with extramedullary manifestations, including leukemia cutis (LC), which is a rare and challenging diagnosis. LC often presents as erythematous or violaceous nodules, plaques, or papules, and its nonspecific clinical appearance can lead to diagnostic delays. We report the case of a 29-year-old man who presented with a painful ulcer on his right anterior leg. The initial clinical evaluation did not suggest a hematologic malignancy, and the diagnosis was elusive. Histopathological examination of the skin biopsy revealed atypical infiltrating cells, but the diagnosis remained uncertain until immunohistochemistry (IHC) and molecular testing were performed. The nonspecific clinical and histopathological features complicated the diagnosis of leukemia cutis in this case. IHC analysis and molecular studies played a critical role in identifying the myeloid origin of the infiltrate. The patient was treated with standard induction chemotherapy, consisting of Cytarabine and daunorubicin, followed by consolidation therapy with high-dose Cytarabine. The patient was free of relapse in a threeyear follow-up after treatment. Early recognition and diagnosis are crucial for initiating appropriate therapy, although the prognosis remains poor due to the aggressive nature of the disease.
Leukemia Cutis in a 32-Year-Old Male with Acute Myeloid Leukemia
Journal of Enam Medical College, 2019
Leukemia cutis (LC) is a rare cutaneous manifestation of leukemia. Clinical presentation of the disease differs among patients depending on types. LC can precede, follow, occur simultaneously with, or present in the absence of the systemic leukemia. Leukemic involvement of the skin may appear as initial manifestation of recurrence or dissemination of systemic disease. Here we report a case of a 32-year-old male patient known to have acute myeloid leukemia with multiple cutaneous lesions diagnosed as LC.
Leukemia cutis from CD56 positive, myeloperoxidase negative acute myeloid leukemia
Acta dermatovenerologica Croatica : ADC, 2013
Acute myeloid leukemia (AML) is a clonal expansion of myeloid blasts in peripheral blood, bone marrow, or other tissues. Cutaneous manifestations of leukemia are either specific or nonspecific. Specific lesions result from direct infiltration of the skin by leukemic cells. We present a case of myeloid leukemia cutis manifested by erythematous asymptomatic nodules and plaques distributed on the chest, abdomen and back. The clinical and histopathologic features of the cutaneous infiltrate were suggestive of hematolymphoid malignancy, more towards lymphoma. However, the immunohistochemical features were against the diagnosis of lymphoma and were highly suspicious of myeloid leukemia, which were concomitantly confirmed by bone marrow biopsy and blood smear. In any poorly differentiated malignant skin infiltrate of confirmed hematopoietic lineage, myeloid differentiation should be considered and excluded by an appropriate panel. CD56+ AML is a rare type of AML that has special features l...
Leukemia cutis and other dermatological findings in pediatric patients with acute myeloid leukemia
Boletín Médico del Hospital Infantil de México, 2021
Background: Leukemia cutis (LC) is the infiltration of neoplastic leukocytes into the skin, causing skin lesions. In children, it appears more frequently in patients with acute myeloblastic leukemia (AML), particularly in subtypes with a monocytic component. Methods: We studied a retrospective cohort including all AML cases from the Hospital Infantil de México Federico Gómez between January 2009 to December 2019 and described the clinical characteristics of those who presented LC and other mucocutaneous manifestations. The information was collected from clinical records and analyzed using SPSS software (version 17). Results: We identified 54 AML cases: 53.7% were males, and 75.9% of the patients presented at least one dermatosis in the course of the disease. LC was clinically present in 14.8% of patients and was histologically confirmed in 9.2% of them; two congenital leukemia cases were identified. Among these patients, LC was more frequent in males. LC patients were younger than those without LC, the most frequent AML subtype was M2 (37.5%), and the most frequent clinical manifestations were plaques, chloromas, and gingival hyperplasia. None of the patients presented LC before AML diagnosis. Conclusions: Currently, only a few studies about LC on pediatric populations have been reported, and the existing ones have small sample sizes. We found clinical and epidemiological similarities with other populations in the studied sample.
B-Cell Acute Lymphoblastic Leukemia Presenting as Leukemia Cutis: A Case Report
Cureus, 2020
Leukemia cutis (LC) is a manifestation of leukemia with infiltration of the dermis, epidermis, or subcutis by malignant leukocytes resulting in papules, plaques, nodules, or ulcers. It is usually associated with acute and chronic myeloid leukemia as well as T-cell acute lymphoblastic leukemia (T-ALL) but is very rare in patients with B-cell acute lymphoblastic leukemia (B-ALL). We report a case of a 58-year-old Hispanic male who presented with a non-healing leg ulcer of three months along with patches on the face, left arm, and bilateral legs with white blood cell (WBC) count of 50800/mm 3 with 83% blasts, and flow cytometry findings of BALL. Punch biopsies from affected skin showed numerous dermal nodules composed of large atypical cells with open chromatin and prominent nucleoli. Immunohistochemical stains were consistent with BALL involving the skin and a diagnosis of LC was rendered. A high index of suspicion in relevant cases and prompt diagnosis is imperative to prevent any delays in appropriate therapy. Diagnosis in our case was aided by concurrent identification of BALL in the patient's peripheral blood. Since this information may not always be available, it is important to keep BALL in the differential any time there is a neoplastic infiltration of leukocytes in the dermis.
A Case of Congenital Leukemia Cutis
Annals of Dermatology, 2009
Congenital leukemia is a rare disease that develops from birth to 6 weeks of life. Leukemia cutis involves cutaneous infiltration by leukemic cells and is an unusual manifestation of leukemia, and has been documented in 25∼30% of patients with congenital leukemia. The authors report a case of congenital leukemia cutis. A newborn male presented with widespread firm dusky red papules and nodules on almost his entire body surface. Skin biopsy specimens confirmed the presence of leukemic infiltrations, and bone marrow cytology was consistent with acute myeloid leukemia of the FAB M5 type. (Ann Dermatol (Seoul) 21(1) 66∼70, 2009
Recurrent leukemia cutis in acute myeloblastic leukemia
1989
We report the case of a 64-year-old female with acute myeloblastic leukemia (French-American-British classification: M2) who developed two specific cutaneous manifestations during her illness. She presented with extensive cellulitis involving the face, neck, and upper chest wall. While the cellulitis resolved with antibiotic therapy, a fungating ulcerated nodule remained on the lower lip which proved to be leukemic on biopsy. Concomitant blood and bone marrow findings were diagnostic of acute myeloblastic leukemia. The lip lesion cleared with a course of chemotherapy. An erythematous macular rash subsequently developed over the lower trunk which was thought to be an allergic reaction to the penicillin treatment. However, biopsy results were consistent with leukemia cutis. A repeat bone marrow examination revealed excessive blasts. Our observations emphasize the various presentations of leukemia cutis and the need to biopsy any cutaneous lesion of unclear etiology in the setting of a...
Chronic Myeloid Leukemia Cutis: A case report
International Journal of Clinical and Diagnostic Pathology, 2021
Leukemia cutis [LC] is the infiltration of neoplastic leukocytes or their precursors into the epidermis, the dermis, or the sub cutis, resulting in clinically identifiable cutaneous lesions. LC may follow, precede, or occur concomitantly with the diagnosis of systemic leukemia. Here we present a case report of Chronic Myeloid Leukemia [CML] cutis in a 32-year-old female who was a known case of CML and presented with multiple erythematous nodules all over her body. Cytological study from the aspirates of these nodules revealed MPO [Myeloperoxidase] positive immature cells from myeloid series.
Leukemia Cutis (Answer to the Clinical Quiz of the Previous Issue)
Shiraz E Medical Journal
Skin infiltration in leukemia occurs rarely. Leukemia cutis has a wide range of cutaneous manifestations from maculopapular to tumorous stage. Patients with Leukemia cutis usually have concomitant systemic leukemia, but occasionally skin involvement precedes the in-volvement of the bone marrow or peripheral blood. Complete remission could be achieved with chemotherapy, however, the long term prognosis is poor.