An unusual presentation of acute monocytic leukemia: a case report

We present a rare case of acute monocytic leukemia (AMoL) in which the initial finding consisted solely of cutaneous leukemic infiltrates without obvious bone marrow involvement. Eight months later a definitive bone marrow diagnosis of AMoL was made. Findings of histologic, immunohistochemical, cytochemical, and ultrastructural studies including postmortem examination are described. We believe that one should consider an extramedullary AMoL if the findings of a positive lysozyme stain and a mild to moderate monocytosis are present.