T-cell prolymphocytic leukemia with cutaneous involvement as the presenting feature

An unusual case of T‐cell prolymphocytic leukemia mimicking a cutaneous vasculitis

“…A broad range of cutaneous findings have been reported in both T‐PLL and CLL, making diagnostic distinction from skin manifestations alone very challenging (Table 1). 2,6‐10,12‐14 One clue that may have suggested T‐PLL rather than CLL was the significant facial lesions and conjunctival involvement in our patient. In contrast to B‐cell lymphoproliferative disorders such as CLL, T‐cell malignancies show a higher rate of cutaneous involvement 6 .…”

“… 2,6‐10,12‐14 One clue that may have suggested T‐PLL rather than CLL was the significant facial lesions and conjunctival involvement in our patient. In contrast to B‐cell lymphoproliferative disorders such as CLL, T‐cell malignancies show a higher rate of cutaneous involvement 6 . The differential diagnosis of other possible T‐cell lymphomas and leukemias in this case would include adult T‐cell leukemia (ATLL), Sézary syndrome, large granular cell lymphocytic leukemia (LGL leukemia), T‐cell lymphoblastic leukemia, and peripheral T‐cell lymphoma not otherwise specified (PTCL‐NOS) 15 .…”

“…Most patients with T‐PLL present with a brief history of B symptoms, hepatosplenomegaly, and a marked lymphocytosis 6 . Anemia and thrombocytopenia are seen in up to one‐half of patients and cutaneous involvement is seen in 25% to 30% of patients 2 .…”

“…T‐PLL typically presents with a history of B symptoms, hepatosplenomegaly, and marked lymphocytosis 5 . The incidence of cutaneous manifestations has been reported to be 25% to 30% 6‐11 . Typical findings involve the face and include swelling and violaceous plaques with a periorbital distribution, but erythematous nodules and plaques on the trunks and limbs have also been reported 7‐9 .…”

“…5 The incidence of cutaneous manifestations has been reported to be 25% to 30%. [6][7][8][9][10][11] Typical findings involve the face and include swelling and violaceous plaques with a periorbital distribution, but erythematous nodules and plaques on the trunks and limbs have also been reported. [7][8][9] Cutaneous involvement typically presents in the context of patients with established history of T-PLL, but it can less frequently present as an initial symptom heralding the diagnosis.…”