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Skin - Nonmelanocytic tumors
Lymphoma and related disorders
Leukemia
Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 15 July 2012, last major update June 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.
General
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● Skin involvement (“leukemia cutis”) occurs in 5% with CML, 8% with CLL, 10% with monocytic leukemia
● Myeloid leukemia with monocytic differentiation more commonly involves the skin than other types of myeloid leukemia
● Usually is abnormal peripheral blood count at diagnosis
● Skin involvement is rarely initial manifestation of recurrence (Am J Clin Pathol 2008;129:130)
● May also have accompanying vasculitis
(Am J Clin Pathol 1997;107:637)
● Aggressive behavior and short survival
(J Am Acad Dermatol 1999;40:966)
Case reports
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● 68 year old woman with history of AML
(Case of Week #140)
Treatment
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● Systemic chemotherapy directed at eradicating the leukemic clone
Gross description
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● Multiple nodules/papules
Micro description
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● In CLL, may be perivascular, periadnexal, nodular or band-like dermal infiltrate
● Infiltrate in leukemic patients is often NOT neoplastic, but reactive
● AML: dermis and superficial subcutaneous fat are diffusely infiltrated by a monotonous population of large cells with a high nuclear to cytoplasmic ratio, round to slightly irregular nuclear contours, finely dispersed chromatin and prominent nucleoli
Micro images
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AML
CD45
CD43
CD117
CD68
Positive stains
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● Myeloblasts: chloroacetate esterase (Leder stain), myeloperoxidase
Additional references
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End of Skin - Nonmelanocytic tumors > Lymphoma and related disorders > Leukemia
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