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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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eMedicine - Leukemia Cutis

End of Skin - Nonmelanocytic tumors > Lymphoma and related disorders > Leukemia


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