A case of leukemia cutis in a patient with acute myelogenous leukemia during hematological remission

Aleukemic leukemia cutis is a rare condition in which malignant white cells invade the skin before they appear in the peripheral blood or bone marrow. It is often associated with a poor prognosis. The condition presents a diagnostic challenge as its manifestations are quite variable terms of lesion type. It can manifest as papules, nodules, and/or plaques, and in rare cases erythematous macules, blisters, and ulcers. The most commonly affected areas of the body are the lower extremities, followed by the upper extremities, back, trunk, and face. Due to the non-specific presentation of the disease, skin biopsy and comprehensive immunohistochemical testing can be extremely helpful in the diagnostic work-up. We describe a case of leukemia cutis presenting prior to acute myelogenous leukemia that was initially misdiagnosed as hyper-IgG4 disease.

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ACUTE MYELOGENOUS LEUKEMIA PRESENTING WITH ABRUPT ONSET LEUKEMIA CUTIS IN A YOUNG BOY: A RARE CASE REPORT

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2015/449 ◽

2015 ◽

Vol 2 (20) ◽

pp. 3086-3091

Author(s):

Lohit Kumar Kalita ◽

Chayanika Kalita ◽

Pabitra Kumar Gogai ◽

Umesh Ch. Sarma

Keyword(s):

Case Report ◽

Acute Myelogenous Leukemia ◽

Rare Case ◽

Abrupt Onset ◽

Myelogenous Leukemia ◽

Rare Case Report ◽

Acute Myelogenous ◽

Leukemia Cutis

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Concurrent Chronic Lymphocytic Leukemia Cutis and Acute Myelogenous Leukemia Cutis in a Patient with Untreated CLL

American Journal of Dermatopathology ◽

10.1097/00000372-200108000-00011 ◽

2001 ◽

Vol 23 (4) ◽

pp. 334-340 ◽

Cited By ~ 19

Author(s):

Michael K. Miller ◽

James A. Strauchen ◽

Khanh T. Nichols ◽

Robert G. Phelps

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Acute Myelogenous Leukemia ◽

Lymphocytic Leukemia ◽

Myelogenous Leukemia ◽

Acute Myelogenous ◽

Leukemia Cutis

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Expression of JL1 Is an Effective Adjunctive Marker of Leukemia Cutis

Archives of Pathology & Laboratory Medicine ◽

10.5858/2008-0699-oar.1 ◽

2010 ◽

Vol 134 (1) ◽

pp. 95-102

Author(s):

Young Soo Park ◽

So Hyung Park ◽

Seo-Jeong Park ◽

Youngji Kim ◽

Kee-Taek Jang ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Acute Myelogenous Leukemia ◽

Immunohistochemical Staining ◽

Lymphoblastic Leukemia ◽

Myelogenous Leukemia ◽

Leukemic Cells ◽

Cutaneous Lesions ◽

Acute Myelogenous ◽

Leukemia Cutis

Abstract Context. Specific differentiation of leukemia cutis (LC) from nonleukemic dermatoses is crucial to ensure proper treatment for the disease. Because of the exceptionally variable histologic features of LC and the frequent nonleukemic dermatoses in leukemia patients, identification of leukemic cells that infiltrate skin lesions is important. Here, we introduce JL1, a novel leukemia-associated surface antigen, which is not expressed in mature human tissue but in cortical thymocytes and small subpopulations of bone marrow hematopoietic precursors. Objectives. To assess the expression pattern of JL1 in LC and compare it with other commonly used markers. Also, to evaluate the expression of JL1 in other cutaneous lesions that need differential diagnoses. Design. Immunohistochemical staining with anti-JL1 and other commonly used markers for LC was performed on paraffin-embedded skin biopsies from 32 cases of LC with acute lymphoblastic leukemia/lymphoma and acute myelogenous leukemia. Immunohistochemical staining score was evaluated in each case according to the proportion of positive tumor cells found. JL1 staining was also done on 96 reactive or neoplastic cutaneous lesions. Results. JL1 was detected in 7 of 11 acute lymphoblastic leukemia/lymphoma LC (63.6%) and 7 of 21 acute myelogenous leukemia LC (33.3%), with invariably high-staining scores. None of the other cutaneous lesions or normal tissues expressed JL1. The expression pattern of JL1 was not altered in 2 patients with follow-up biopsies. Conclusions. Our finding that JL1 is expressed exclusively and stably by leukemic cells suggests that it can be used as a useful adjunctive marker for initial diagnosis and follow-up biopsy of LC, particularly in cases of scarce infiltrates.

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