Aleukemic Leukemia Cutis

Abstract

A 46-year-old man presented with nodular skin lesions, a biopsy specimen of which demonstrated a poorly differentiated malignancy. Touch preparations with histochemical staining and electron microscopy confirmed leukemia cutis. Results from a bone marrow aspirate disclosed focal areas of increased myeloblasts, and cytogenetic analysis revealed an abnormal karyotype as follows 46,XY, t(1;2) (q44p13). Antileukemic therapy resulted in prompt disappearance of the skin nodules, and a return of the patient's bone marrow to normal was noted, but after six months of intensive chemotherapy leukemia cutis recurred without morphologically identifiable leukemia in the bone marrow. The patient underwent successful bone marrow transplantation from an HLA-identical sibling but died 70 days after the transplant from disseminated aspergillosis.

Neonatal leukaemia cutis

“…65 This aleukaemic leukaemia cutis presentation may spontaneously resolve, although in the majority of cases the patients progress to systemic involvement within the subsequent four months. 4,7,20,57,[66][67][68][69][70][71][72][73][74][75] A 2013 retrospective study of 83 patients aged 2 weeks to 89 years of age with myeloid leukaemia cutis published that 6/34 (18%) patients had aleukaemic leukaemia cutis presentations but that all 34 developed a bone marrow based diagnosis of AML. 6 In addition, 10 of 29 (34%) individuals with charted cytogenetic or molecular genetic results available had an abnormality of the chromosome 11q23 that includes the mixed lineage leukaemia (MLL) locus.…”

Leukemia Cutis in Acute Myelomonocytic Leukemia: Infiltration to Minor Traumas and Scars

“…Although most extramedullary leukemic infiltration occurs late in the disease, leukemia cutis may be seen in patients with normal or even low white blood cell counts in the peripheral blood. In addition, leukemia cutis may be the first sign of the blastic leukemic transformation of myelodysplastic syndrome (6,8,9). There have been several reported cases of leukemia cutis as the initial manifestation of leukemia relapse or as a precursor ofleukemia cell appearance in the peripheral blood (6,8,10).…”

“…In addition, leukemia cutis may be the first sign of the blastic leukemic transformation of myelodysplastic syndrome (6,8,9). There have been several reported cases of leukemia cutis as the initial manifestation of leukemia relapse or as a precursor ofleukemia cell appearance in the peripheral blood (6,8,10). Cutaneous infiltration by leukemic cells is regarded as one sign of a poor prognosis (2).…”

Cutaneous Myeloid Sarcoma Presenting as Grey Pigmented Macules

“…Non-specific lesions are found in up to 30% of leukaemia patients (1), but leukaemia cutis is much less common. Skin involvement is usually a late occurrence, and leukaemia cutis preceding marrow or peripheral blood abnormality is extremely rare (2). The clinical manifestations of leukaemia cutis are variable, including macules, nodules, purpura, and erythroderma, and the condition often resembles cutaneous lymphoma.…”