Unusual cutaneous manifestations of B-cell chronic lymphocytic leukemia

[Guest guest]

Unusual cutaneous manifestations of B-cell chronic lymphocytic leukemia.

JA Plaza, NI Comfere, LE Gibson, M Colgan, DM , MR Pittelkow, and JP Colgan

J Am Acad Dermatol, May 1, 2009; 60(5): 772-80.

Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA.

BACKGROUND: B-cell chronic lymphocytic leukemia (B-CLL) is a low-grade

lymphoproliferative disorder with characteristic histomorphologic features and

an identifiable immunophenotype. The skin can be involved in the context of

known disease, but cutaneous signs are rarely the presenting findings.

OBJECTIVE: Evaluation of unusual clinical cutaneous presentations of B-CLL.

METHODS: We conducted a retrospective case series analysis of 3 patients with

unusual cutaneous clinicopathologic presentations of B-cell chronic lymphocytic

leukemia, including erythematous plaques, angiomatosis/telangiectasia, and

erosive skin changes, respectively, without a previous clinical history of

chronic lymphocytic lymphoma. Main outcome measures were clinical cutaneous

presentations and histopathologic results in the diagnosis of underlying

disease. RESULTS: In the 3 cases, lesion locations were the lower cheek, lower

extremity, and penis (groin region). Histomorphologic testing showed mild to

dense perivascular and periadnexal lymphoid aggregates throughout the dermis and

extending into the panniculus, consistent with B-CLL. The diagnosis was

confirmed with immunohistochemical studies that showed coexpression of CD5 and

CD20 in the neoplastic lymphocytic infiltrate. LIMITATIONS: None. CONCLUSION:

Cutaneous manifestations are an uncommon presentation of subclinical B-CLL.

Cutaneous changes were the presenting features of underlying lymphoma in all 3

cases, highlighting the importance of maintaining a high index of suspicion for

a lymphoproliferative process in cases with unusual or atypical

clinicopathologic features. Additional investigations into the behavior of B-CLL

in the skin may elucidate further the evolution of cutaneous lesions in this

disease.

PMID: 19389520

----------

----------

No virus found in this outgoing message.

Checked by AVG - www.avg.com

Version: 8.0.238 / Virus Database: 270.12.6/2084 - Release Date: 04/28/09

06:15:00