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Leukemia cutis in association with cutaneous epidermal malignancies
Author(s) -
Ra Seong,
Su Albert,
Ellison Doug,
Koperski Judith,
Bonilla Maria,
Robbins Bruce
Publication year - 2012
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.1600-0560.2012.01978.x
Subject(s) - leukemia cutis , medicine , pathology , cd117 , myeloid , myeloid leukemia , biopsy , malignancy , skin biopsy , leukemia , cutis , cd34 , bone marrow , immunology , stem cell , biology , genetics
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.