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B-cell acute lymphoblastic leukemia with aleukemic leukemia cutis


European Journal of Dermatology. Volume 11, Number 2, 151-2, March - April 2001, Votre diagnostic !

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Author(s) : Hiroshi KISHIMOTO, Yoshihiko FURUI, Kiyoshi NISHIOKA

Summary : A 70-year-old Japanese woman was referred to us in August 1999 with a 2-month history of skin lesions. Examination revealed multiple dark-purple to red, 10 to 40 mm, firm nodules on her left arm (Fig. 1) and back. Blood cell count was as follows: red blood cell count, 4.07 x 106/mm3; hemoglobin, 9.5 gm/dl; white blood cell count, 5,360/mm3 with 3% stab cells, 54% segmented neutrophils, 39% lymphocytes, 2% monocytes, and 2% eosinophils; and platelets, 185,000/mm3. No antibodies were detected to the human T cell leukemia virus type 1 or the human immunodeficiency virus. The multiphasic biochemistry series were within normal limits. A biopsy specimen taken from a nodule on her left forearm revealed a dense infiltrate of blastlike lymphoid cells in the dermis with occasional mitotic figures and a grenz zone (Fig. 2). Formation of germinal center was not seen.

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