Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare malignancy with skin tropism. The entity was recently defined and the diagnosis is generally made by skin biopsies. It is necessary to apply appropriate immunohistochemistry to recognize this rare entity. There is no consensus on therapy and the survival rates are low. The aim of this study is to describe the clinical and histopathological features of BPDCN. We retrospectively reviewed 8 BPDCN cases of the Cerrahpaşa Medical Faculty diagnosed between 2005 and 2019. We documented the clinical findings, histopathologic diagnoses, and outcomes. The mean age of the patients was 58.7 years (range=11-86 years), and 7 patients were male. The patients presented with erythematous or purple papules, plaques, and papulonodular or nodular cutaneous lesions. Two had lymphadenomegaly at presentation. In microscopic evaluations, tumor cells infiltrated the entire dermis with a clear-cut subepidermal Grenz zone in all cases. CD4, CD56, and CD123 were the most frequently expressed immunohistochemical markers. The median follow-up of 7 cases was 14 months, ranging from 6 to 48 months. Three patients died of the disease, while 4 patients were still alive. Out of 7 patients, 5 received chemotherapy. We found that the outcomes of some patients were different from others but we did not link any distinct clinical or histopathological characteristics to these different outcomes.

Highlights

  • The aim of this study is to describe the clinical and histopathological features of Blastic plasmacytoid dendritic cell neoplasm (BPDCN)

  • Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive tumor derived from the precursors of plasmacytoid dendritic cells (PDCs) with a high frequency of cutaneous and bone marrow involvement and leukemic dissemination [1]

  • The tumor is considered among the “acute myeloid leukemia and related neoplasms” since 2008 [2] and recently it was reclassified as a separate entity in the latest World Health Organization classification scheme

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Summary

Introduction

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive tumor derived from the precursors of plasmacytoid dendritic cells (PDCs) with a high frequency of cutaneous and bone marrow involvement and leukemic dissemination [1]. The tumor is considered among the “acute myeloid leukemia and related neoplasms” since 2008 [2] and recently it was reclassified as a separate entity in the latest World Health Organization classification scheme. The tumor cells typically express CD4, CD56, CD43, CD45RA, and plasmacytoid dendritic cell antigens (CD123, CD303, TCL1A, CD2AP, SPIB, and type 1 interferon-dependent molecule MX1) [3]. The molecular profile showed that this entity is much more related to myeloid neoplasms [4]. We present 8 patients with BPDCN from a single center to emphasize the clinical and histopathological features of this rare entity.

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