Clinical and pathological characteristics of myelogenous leukemia with skin infiltration

Abstract

Objective To study the clinical,histopathological and immunohistochemical features of myelogenous leukemia with skin infiltration.Methods This study included 6 patients with myelogenous leukemia with skin infiltration diagnosed at Peking Union Medical College Hospital from July 2002 to July 2011.The clinical,histopathological and immunohistochemical findings in these patients were analyzed retrospectively.Results Leukemia cutis was the initial presentation in 1 patient,and skin infiltration developed within 4 to 20 months after the diagnosis of leukemia in 5 patients.Of these patients,4 presented with generalized erythematous infiltrated papules,maculopapules or nodules,and 2 with localized masses.Biopsy showed massive infiltration of the dermis and subcutaneous fat layer with tumor cells,most of which were positive for myeloperoxidase,CD43 and CD45,and some for CD15,granzyme B,leukocyte common antigen and CD68.Five patients with acute myelogenous leukemia all died within 60 days to 1 year after skin infiltration occurred.Conclusions In patients with myelogenous leukemia,skin infiltration usually occurs after,but occasionally before,the appearance of abnormal haemogram and myelogram,and the presence of skin infiltration is often associated with a poor prognosis and short survival.Myelogenous leukemia with skin infiltration often presents as generalized or localized nodules or masses with characteristic pathological and histochemical manifestations. Key words: Skin manifestations; Leukemia, myeloid; Leukemic infiltration