Yonal Ipek, Hindilerden Fehmi, Coskun Raif, Dogan Oner Ibrahim, Nalcaci Meliha
Division of Hematology, Department of Internal Medicine, Istanbul, Turkey. ipekyonal @ yahoo.com.tr
Case Rep Oncol. 2011 Sep;4(3):547-54. doi: 10.1159/000334745. Epub 2011 Nov 22.
Aleukemic leukemia cutis (ALC), a discrete tumor of leukemic cells involving the skin, may be the first manifestation of acute myeloid leukemia, preceding the onset in marrow and blood by months and years. ALC is often difficult to diagnose and is associated with a dismal prognosis. A 63-year-old male presented with nodular swellings on the face, a plaque extending over the right shoulder and multiple enlarged cervical lymph nodes. The skin biopsy of the plaque lesion showed a diffuse neoplastic infiltration extending from the dermis to subcutaneous tissue with diffuse positivity for myeloperoxidase and focal positivity for CD34 on immunohistochemical staining. The diagnosis was leukemia cutis. One month later, acute monocytic leukemia (FAB AML-M5b) was diagnosed. The patient died on the seventh month of diagnosis.
非白血性白血病皮肤浸润（ALC）是白血病细胞累及皮肤的一种离散性肿瘤，可能是急性髓系白血病的首发表现，比骨髓和血液发病早数月至数年。ALC常难以诊断，且预后不佳。一名63岁男性患者出现面部结节性肿胀、右肩部的斑块以及多处颈部淋巴结肿大。斑块病变的皮肤活检显示从真皮至皮下组织有弥漫性肿瘤浸润，免疫组化染色髓过氧化物酶弥漫阳性，CD34局灶阳性。诊断为白血病皮肤浸润。1个月后，诊断为急性单核细胞白血病（FAB AML-M5b）。患者在诊断后第7个月死亡。
