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Leukemia cutis with prominent giant cell reaction
F K Baksh1, D Nathan, W Richardson
1Department of Pathology, Eastern Virginia Medical School, Norfolk 23507, USA.
Insights
Leukemia cutis can mimic chronic granulomatous inflammation due to giant cells. This case highlights the importance of considering myeloid leukemia in skin lesions with immature myeloid cells, even with granulomatous features.
Area of Science:
- Dermatopathology
- Hematology
- Oncology
Background:
- Leukemia cutis, a neoplastic infiltration of the skin by leukemic cells, can present with diverse histopathological features.
- Giant cell reactions in skin biopsies can sometimes obscure the underlying neoplastic process.
Observation:
- A skin lesion initially diagnosed as chronic granulomatous inflammation was found to have a prominent giant cell component.
- Histopathological examination revealed numerous Langhans-type giant cells alongside a significant infiltrate of immature myeloid cells.
Findings:
- The immature myeloid cells in the skin infiltrate were positive for chloroacetate esterase, lysozyme, and CD 68.
- Peripheral blood and bone marrow examinations confirmed the progression to acute myeloid leukemia.
Implications:
- This case underscores the diagnostic challenge posed by leukemia cutis mimicking inflammatory conditions.
- Accurate histopathological and hematological evaluation is crucial for the timely diagnosis and management of myeloid leukemia with cutaneous involvement.
Abstract:
We present a case of leukemia cutis associated with a prominent giant cell component. This lesion was initially diagnosed as chronic granulomatous inflammation 1 year before the definitive diagnosis of leukemia cutis was made. Skin biopsy specimens showed numerous Langhans-type giant cells occurring singly and as poorly formed granulomas. However, the majority of the infiltrate consisted of immature myeloid cells, positive for chloroacetate esterase, lysozyme, and CD 68. Subsequent peripheral blood and bone marrow examinations confirmed the progression of the disease to acute myeloid leukemia.
