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‘Specific’ cutaneous infiltrate of B‐cell chronic lymphocytic leukemia at the site of a florid herpes simplex infection
Author(s) -
Ziemer Mirjana,
Bornkessel Anja,
Hahnfeld Sabine,
Weyers Wolfgang
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.00377.x
Subject(s) - leukemia cutis , pathology , chronic lymphocytic leukemia , cd20 , cd5 , leukemia , medicine , neoplastic cell , immunology , lymphoma , biology , cell , bone marrow , genetics
Background: Specific cutaneous infiltrates in patients with leukemia generally carry a grim prognosis. However, non‐neoplastic skin diseases may be associated with recruitment of normal and neoplastic leukocytes circulating in the peripheral blood. In those instances, neoplastic cells may be detected in skin lesions without an adverse effect on prognosis. Methods: In a patient with B‐cell chronic lymphocytic leukemia, a specific infiltrate developed at the site of a florid herpes simplex infection. Clinically, the lesion presented itself as an ulcerated tumor. Results: Histopathologically, the lesion was characterized by a dense, diffuse infiltrate of small hyperchromatic lymphocytes throughout the entire dermis. Lymphocytes showed an aberrant CD20 + /CD43 + /CD5 + phenotype of neoplastic B cells, and monoclonal rearrangement of immunoglobulin gamma genes could be demonstrated by polymerase chain reaction. Although criteria for leukemia cutis were fulfilled, the patient did well. Conclusions: The cutaneous infiltrate of neoplastic cells seemed to be part of a physiologic response to the antigenic stimulus, rather than indicating an exacerbation of leukemia.