Cutaneous presentation of aleukemic monoblastic leukemia cutis – a case report and review of literature with focus on immunohistochemistry

Abstract

PCALCL is characterized by variable histopathological presentations and a broad cytomorphologic spectrum.

Pediatric Aleukemic Leukemia Cutis

“…Although less common, LC can also be present in patients with lymphoblastic leukemias, with an estimated incidence in 1.3% of patients. 1,7,8,[10][11][12][13][14][15]17,21,25,[32][33][34][35][36][37][38][39] Though most commonly associated with myeloid leukemias, ALC can also be seen in association with pre-B-cell ALL 9,17,20 and in rare cases of T-cell ALL. 2,3,29 Interestingly, Longacre et al 30 reviewed 123 skin biopsies of leukemic patients who had no clinical skin findings and found LC in 30% of cases.…”

“…1 However, LC has also been described in association with chronic myelogenous leukemia, myelodysplastic syndromes (MDS), and acute lymphoblastic leukemias (T-ALL and B-ALL). [6][7][8] Rarely, cutaneous involvement by a leukemic infiltrate can occur in the absence of bone marrow or peripheral blood involvement by acute leukemia; this then is referred to as aleukemic LC (ALC) [9][10][11][12][13][14][15][16][17] or aleukemic myeloid sarcoma. Myeloid sarcoma, extramedullary myeloid tumor, granulocytic sarcoma, and monocytic sarcoma are often termed LC when occurring in the skin.…”

Aleukemic cutaneous myeloid sarcoma

“…As Hejmadi et al spotlight in their review, monoblasts tend to pose a particular problem with regard to immunohistochemistry in so far as they tend to be negative for hemopoietic precursor cell antigens such as CD34 and CD117 . Amador‐Ortiz et al found that a panel including CD117, CD33 and lysozyme could detect all cases of CMS, and furthermore, the addition of CD14, and Kruppel‐like factor 4 (KLF‐4) could identify leukemias with monocytic differentiation with a fairly high degree of sensitivity and specificity .…”

Leukemia Cutis Amidst a Psoriatic Flare

“…Aleukemic leukemia cutis is the rare occurrence of leukemic cells infiltrating the skin before their appearance in the blood or bone marrow. [1][2] The clinical morphology of LC may vary in color, size, and distribution and may emerge as nodules, ulcers, macules, papules, or plaques. 3 In addition, Angulo et al 4 reported a case of LC presenting as cutaneous hyperpigmentation, originally attributed to the chemotherapies utilized during treatment, which was later discovered to be LC.…”