Chronic Myeloid Leukemia Cutis: A case report (original) (raw)
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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 in association with cutaneous epidermal malignancies
Journal of Cutaneous Pathology, 2012
Leukemia cutis in association with cutaneous epidermal malignancies Background: Epidermal malignancies developing in association with hematolymphoid malignancies are exceptional. Only one prior case of myeloid leukemia cutis with a cutaneous epidermal malignancy has been reported. Methods: We report two cases; one occurred in association with squamous cell carcinoma (SCC) and another with basal cell carcinoma (BCC). Results: Both patients were 83-year-old males without established histories of systemic hematopoietic disorders; one presented with an erythematous papule on the right upper back and the other with a nodule on the left wrist. One biopsy revealed nodular BCC with an associated perivascular myeloid leukemic infiltrate showing immunohistochemical positivity for CD43 and CD45. The other biopsy showed SCC associated with a leukemic infiltrate in sheets with myeloid blasts, eosinophilic myelocytes and maturing myeloid precursors. The myeloid cells showed immunohistochemical expression of CD43, CD68, CD33, CD117 and myeloperoxidase. Both patients had myeloblasts on peripheral blood smear. One patient declined further treatment and died of disease 5 weeks after the initial biopsy. The other patient underwent chemotherapy and is alive after 6 months. Conclusion: Although most inflammatory infiltrates associated with cutaneous epidermal malignancies are reactive, careful examination is necessary to exclude systemic hematopoietic disease, especially in elderly patients. cutis in association with cutaneous epidermal malignancies. J Cutan Pathol 2012; 39: 971-976.
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.
The American Journal of Dermatopathology, 1997
Few recent studies have analyzed the clinicopathologic features of specific cutaneous manifestations of myelogenous leukemia in a large number of patients. We characterize the clinical and histopathologic spectrum of specific cutaneous manifestations in acute (AML) and chronic (CML) myelogenous leukemia, ascertain further diagnostic criteria, and examine current prognosis. Thirty-six lesions of specific cutaneous infiltrates from 26 patients with myelogenous leukemia (AML: 17 patients; M:F = 1:2.4; mean age: 52.6 years; AML-French-American-British [FAB] classification subtypes:M1 = 1, M2 = 3, M4 = 8, M5 = 5. CML = 9 patients; M:F = 4.5:1; mean age: 60.6 years) were retrospectively collected for the study. Cutaneous manifestations presented as solitary or multiple reddish to violaceous papules, plaques, and nodules (17 lesions), or as a generalized erythematous maculopapular eruption (9 lesions). Concurrent extramedullary involvement in other peripheral sites (eg, gums, pharynx, orbits) was observed in 10 patients. Histopathologically, lesions revealed nodular/diffuse infiltrates, often with perivascular and periadnexal accentuation, sparing of the upper papillary dermis, and prominent single arraying of neoplastic cells between collagen bundles. Extension to the subcutis was noted in all deep biopsy specimens (26 lesions). Cytomorphologically, medium to large-sized mononuclear cells (myeloblasts and atypical myelocytes) predominated in AML-M1 and M2, whereas M4 and M5 mainly showed small, medium-sized, or large mononuclear cells with slightly eosinophilic cytoplasm and indented, bi-lobular, or kidney-shaped nuclei (atypical monocytoid cells). In CML, either a variable mixture of mature and immature cells of the granulocytic series (myelocytes, metamyelocytes, eosinophilic metamyelocytes, and neutrophils) or a rather monomorphous infiltrate of mononuclear cells were found. Staining for naphthol AS-D chloroacetate-esterase (NASD) was positive in 24 of 36 lesions (66.6%; AML: 16; CML: 8). Immunohistochemical analysis on paraffin sections using a large panel of antibodies (16 lesions: AML: 13; CML: 3) showed strong reactivity for LCA (CD45), lysozyme, myeloperoxidase (MPD), LN2 (CD74), HLA-DR, and MT1 (CD43) in the majority of cases, and variable staining for monocyte/macrophage markers (KP1/CD68, PGM1/CD68, Mac387, Ki-M1p). The neuronal cell adhesion molecule (NCAM) marker CD56 was reactive in 2 cases of CML, but negative in all cases of AML. MIB1(Ki67) stained 20% to 80% of neoplastic cells. CD34, CD15, CD20, and CD3 were negative in all cases. No correlation between histochemical/immunohistochemical features with type of leukemia or FAB-subtype of AML was observed. All patients with CML and AML with adequate follow-up died within 24 months after onset of skin lesions (mean survival, AML: 7.6 months; CML: 9.4 months). Specific cutaneous lesions in AML and CML show distinctive clinicopathologic features that allow diagnosis in most cases. Immunohistochemistry on routinely fixed, paraffin-embedded tissue sections provides useful adjunctive information. Simultaneous expression of lysozyme, MPD, CD45, CD43, and CD74 militates in favor of a diagnosis of specific cutaneous infiltrate of myelogenous leukemia. Pitfalls in immunohistologic diagnosis mainly include lack of expression of some myeloid markers (lysozyme, MPD), and aberrant expression of T-cell markers (eg, CD45RO). Regardless of type of myelogenous leukemia, onset of specific skin manifestations correlates with an aggressive course and short survival.
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.
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...
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.
Clinical characteristics of 75 patients with leukemia cutis
Journal of Korean medical science, 2013
Leukemia cutis (LC) is defined as a neoplastic leukocytic infiltration of the skin. Few clinical studies are available on recent trends of LC in Korea. The purpose of this study was to analyze the clinical features and prognosis of LC in Korea and to compare findings with previous studies. We performed a retrospective study of 75 patients with LC and evaluated the patients' age and sex, clinical features and skin lesion distribution according to the type of leukemia, interval between the diagnosis of leukemia and the development of LC, and prognosis. The male to female ratio was 2:1, and the mean age at diagnosis was 37.6 yr. The most common cutaneous lesions were nodules. The most commonly affected site was the extremities in acute myelocytic leukemia and chronic myelocytic leukemia except for acute lymphocytic leukemia. Compared with previous studies, there was an increasing tendency in the proportion of males and nodular lesions, and LC most often occurred in the extremities....
Case Report Mixed Phenotype Acute Leukemia Presenting as Leukemia Cutis
Leukemia cutis (LC) is defined as infiltration of the skin by leukemic cells resulting in clinically recognizable cutaneous lesions. It is common in congenital leukemia and acute myeloid leukemia. However, LC has rarely been reported with mixed phenotypic acute leukemia (MPAL). We report the case of a lady who presented with erythematous papular and nodular lesions all over the body. Skin biopsy showed leukemic infiltration and bone marrow aspiration showed MPAL of the T/myeloid with monocytic differentiation lineage. This is the first report of an adult patient with MPAL of the T/myeloid with monocytic differentiation type presenting with leukemia cutis. She was started on chemotherapy with Hyper-CVAD. There is complete resolution of the skin lesions and she has achieved bone marrow remission after the first cycle of chemotherapy.