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Congenital leukemia cutis.

Anne B Fender1, Anthony Gust, Nancy Wang

  • 1Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine, Rochester, New York 14642, USA.

Pediatric Dermatology
|February 29, 2008
PubMed
Summary
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A premature infant presented with pancytopenia and a solitary skin nodule, diagnosed as acute myelogenous leukemia. This rare presentation highlights the importance of considering leukemia in neonates with isolated skin lesions.

Area of Science:

  • Neonatal Hematology
  • Pediatric Oncology
  • Dermatopathology

Background:

  • Acute myelogenous leukemia (AML) is rare in neonates.
  • Leukemia cutis, a manifestation of leukemia in the skin, typically presents as multiple lesions.

Observation:

  • A premature neonate presented with pancytopenia and a single subcutaneous nodule.
  • Biopsy revealed a dense infiltrate of pleomorphic mononuclear cells, consistent with leukemia cutis.

Findings:

  • Immunohistochemistry and bone marrow examination confirmed acute myelogenous leukemia.
  • Cytogenetic analysis showed an abnormal karyotype with an insertion and inversion.
  • Fluorescence in situ hybridization identified a mixed lineage leukemia gene rearrangement.

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Implications:

  • This case emphasizes that leukemia cutis can present as a solitary nodule in neonates.
  • Early consideration of leukemia is crucial for diagnosing unusual neonatal skin lesions.
  • The findings underscore the aggressive nature of neonatal AML.