Dekio I, Anzai H, Ohyama M, Tanikawa A, Amagai M, Yokoyama K, Okamoto S, Tanaka M
Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
J Eur Acad Dermatol Venereol. 2006 Apr;20(4):453-6. doi: 10.1111/j.1468-3083.2006.01491.x.
Aleukaemic leukaemia cutis is a rare condition characterized by infiltration of leukaemic cells into the skin before they appear in the peripheral blood. We report a case of an aleukaemic leukaemia cutis, which had a history of exposure to atomic bomb radiation. A 57-year-old Japanese woman initially presented with a 20-week history of multiple red papules and plaques mainly over the trunk. Histological examination revealed the infiltration of atypical monocytic cells in the dermis, but no leukaemic cells were detected in the peripheral blood. Twenty-three weeks after the appearance of the eruption, leukaemic cells were detected in the peripheral blood for the first time. The results of immunohistochemistry of the skin biopsy specimen and flow cytometry of the peripheral blood indicated the rare phenotype of myeloid/NK cell precursor acute leukaemia. This is the first case report of myeloid/NK cell precursor acute leukaemia presenting as aleukaemic leukaemia cutis in the English literature, and awareness of this clinical presentation may be important to reach the correct diagnosis.
非白血性白血病性皮肤浸润是一种罕见病症，其特征为白血病细胞在出现在外周血之前就浸润至皮肤。我们报告一例有原子弹辐射暴露史的非白血性白血病性皮肤浸润病例。一名57岁日本女性最初表现为主要分布于躯干的多个红色丘疹和斑块，病程20周。组织学检查显示真皮中有非典型单核细胞浸润，但外周血中未检测到白血病细胞。皮疹出现23周后，外周血中首次检测到白血病细胞。皮肤活检标本的免疫组化结果及外周血的流式细胞术结果显示为髓系/NK细胞前体急性白血病的罕见表型。这是英文文献中首例以非白血性白血病性皮肤浸润形式出现的髓系/NK细胞前体急性白血病病例报告，认识到这种临床表现对于做出正确诊断可能很重要。
