Premium
Subclinical Chronic Lymphocytic Leukemia Associated with a 13Q Deletion Presenting Initially in the Skin: A Propos of a Case.
Author(s) -
Seilstad K,
Khandelwal A,
Gupta K,
Byrd J,
Magro C
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.0303-6987.2005.320gr.x
Subject(s) - chronic lymphocytic leukemia , pathology , lymphocytosis , medicine , subclinical infection , cd5 , context (archaeology) , leukemia , lymphoma , immunology , biology , paleontology
Introduction: B‐cell chronic lymphocytic leukemia (B‐CLL) represents a low grade B cell lymphoproliferative disease with overlapping features with small lymphocytic lymphoma. The neoplastic cell is an autoreactive CD5 CD23 B lymphocyte. B‐CLL may involve the skin, typically in the context of known disease. We present a case of subclinical B‐CLL presenting initially in the skin. Results: A 73‐year‐old male developed a lesion on his right cheek in April 2003 compatible with basal cell carcinoma. The re‐excision specimen contained a well differentiated atypical lymphocytic infiltrate consistent with B‐CLL along with residual carcinoma. Subsequent laboratory studies revealed slight thrombocytopenia and mild peripheral blood lymphocytosis. A diagnosis was made of stage 0 CLL. Chromosomal studies on peripheral blood showed a deletion at 13q14.3. Conclusion: This case represents a cutaneous presentation of subclinical B‐CLL. There are two prior reports describing B‐CLL presenting initially in the skin. In one case the infiltrates were incidental on a re‐excision specimen. The second report suggests 16% of B‐CLL patients have cutaneous manifestations as the first sign of disease. Data indicates that 13q14 deletion in B‐CLL in early stage disease may portend a more aggressive course, possibly explaining its early presentation in the skin in our case.