Extensive cutaneous manifestations: Presenting feature of chronic myelocytic leukemia in second blast crisis

Singhal, Manish; Singh, Sarika; Kumar, Rajive; Raina, Vinod

doi:10.4103/0019-5154.70682

Cited by 4 publications

(10 citation statements)

References 7 publications

(15 reference statements)

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“…Leukemic infiltrates present as variety of skin lesions such as macules, papules, plaques, nodules and ulcers (5). Lesions can be erythematic or purpuric, presence of vesicles and bullae may represent unusual hypersensitivity reaction (2). In the present case the skin nodules were see as large firm nodules ranging from 1-5 cms and the largest nodule measuring 5x3 cms.…”

Section: Discussionsupporting

confidence: 45%

“…In our present case we see leukemia cutis manifestation in a chronic myeloid leukemia. Leukemia cutis is reported in 2-8% cases of CML (2).…”

Section: Discussionmentioning

confidence: 99%

“…90% of leukemia cutis may have other extramedullary involvement. (2) Cutaneous lesions in leukemias can be of neoplastic and of paraneoplastic types. Leukemic infiltrates present as variety of skin lesions such as macules, papules, plaques, nodules and ulcers (5).…”

Section: Discussionmentioning

confidence: 99%

“…They include erythema nodosum, erythema annulare centrifugum, pyoderma gangrenosum, guttate psoriasis, vitiligo, stasis dermatitis and lesions mimicking urticaria. (2).leukemia cutis should be differentiated from sweet syndrome which is an acute febrile neutrophilic dermatosis found in patients of haematological malignancies (2).…”

Section: Discussionmentioning

confidence: 99%

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Leukemia Cutis- A Case Report

Nirmala¹,

Kulkarni²

2013

jemds

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Leukemic cells infiltrating the dermis are referred to as leukemia cutis. Leukemia cutis is seen in myeloid and lymphoid leukemias. Granulocytic sarcoma presenting primarily as skin nodule [leukemia cutis] in CML is a rare entity. Presence of leukemia cutis points towards blast crisis and poorer prognosis even when the hematological parameters point towards a chronic phase. The authors report a case of Leukemia cutis in Chronic Myeloid Leukemia presenting with multiple large skin nodules all over the body. The clinicopathological features of this variant with FNAC cytology, skin biopsy and histopathology findings and peripheral blood smear are discussed with full details. KEY WORDS; CML, Leukemia cutis, Granulocytic sarcoma (GS). INTRODUCTION: Leukemic cells infiltrating the dermis are referred to as leukemia cutis. Leukemia cutis is seen in myeloid and lymphoid leukemias. Leukemia cutis is a rare presentation of Granulocytic sarcoma. Granulocytic sarcoma (chloroma) is formation of localized tumor mass in any part of the body, composed of granulocytic series of cells seen in myeloid leukemias. Granulocytic sarcoma is reported in 3-9% cases of acute and chronic myelogenous leukemia (1). The authors report a case of Leukemia cutis in Chronic Myeloid Leukemia presenting with multiple large skin nodules all over the body. The clinicopathological features of this variant are discussed with full details. CASE REPORT: A 33 yr old male presented with multiple cutaneous nodules over the face, back, anterior chest wall and limbs, associated with fever for duration of 3 months. The patient was referred from the dermatology department with a provisional diagnosis of leishmaniasis for FNAC of the skin nodules. On examination the skin nodules were of varying sizes ranging from 1-5 cms, largest measuring 5x3 cms and average size being 2x1 cms. The nodules were present all over the body, more on face, back, chest wall and limbs. [Fig 1]The nodules were firm to hard and non tender on palpation. FNAC was performed at multiple sites from multiple nodules. Aspiration was

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Section: Discussionsupporting

confidence: 45%

“…In our present case we see leukemia cutis manifestation in a chronic myeloid leukemia. Leukemia cutis is reported in 2-8% cases of CML (2).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Leukemia Cutis- A Case Report

Nirmala¹,

Kulkarni²

2013

jemds

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“…leukemidu, wśród nich należy wymienić: versity, skin lesions developing in the course of leukaemia may pose a significant diagnostic problem [9]. In the case of CML, skin infiltration by leukemic cells is rare (2-8% of patients), and non-specific, noncarcinomatous skin lesions are much more common in those patients [10]. Carcinomatous erysipelas is a rare form of metastasis, in which cancer cells spread via superficial lymphatic vessels [11].…”

Section: Discussionmentioning

confidence: 99%

Erysipelas in an atypical location

Wańczyk-Dręczewska¹,

Owczarczyk‐Saczonek²,

Placek³

2020

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Chronic myeloid leukemia‐leukemia cutis mimicking a neutrophilic panniculitis‐like leukemia cutis: Report of a rare case

et al. 2021

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While drug‐induced panniculitis is not uncommon in chronic myeloid leukemia (CML) patients on tyrosine kinase inhibitor therapy, it is rare for CML to initially present as a leukemic panniculitis. We present the case of a 45‐year‐old male with no relevant prior medical history presenting with 6 months of migratory nodules, 2 months of drenching night sweats, and a 20 pound weight loss. Physical examination showed firm subcutaneous nodules with overlying ecchymoses present on the right lateral thigh and left lower back. Biopsy of a nodule from the right thigh showed a subcutaneous lobular panniculitis involved by a dense infiltrate of neutrophils and granulocyte precursors. Fluorescent in‐situ hybridization (FISH) was positive for t(9;22)(q34;q11.2)BCR‐ABL1 fusion. A concurrent hemogram revealed a white blood cell count elevation of 600,000 K/μL. Bone marrow biopsy examination showed marked myeloid expansion with an increase in granulocyte precursors and Philadelphia chromosome positivity by FISH, consistent with bone marrow involvement by CML. Herein, we describe this unusual and rare case of CML initially presenting as a neutrophilic panniculitis‐like leukemia cutis. Arriving at this challenging diagnosis may be easily missed without clinical and laboratory correlation, which would certainly lead to the patient's not receiving life‐saving treatment.

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Extensive cutaneous manifestations: Presenting feature of chronic myelocytic leukemia in second blast crisis

Cited by 4 publications

References 7 publications

Leukemia Cutis- A Case Report

Leukemia Cutis- A Case Report

Erysipelas in an atypical location

Chronic myeloid leukemia‐leukemia cutis mimicking a neutrophilic panniculitis‐like leukemia cutis: Report of a rare case

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