Horlick H P, Silvers D N, Knobler E H, Cole J T
Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032.
Arch Dermatol. 1990 May;126(5):653-6.
Aleukemic leukemia cutis is a rare condition in which patients have skin lesions containing leukemic cells before evidence of leukemia can be detected in the peripheral blood. There are only 23 cases of this phenomenon documented in the English literature. We describe a 62-year-old woman who developed a diffuse, clinically benign-appearing cutaneous eruption, which histologically showed an atypical infiltrate of cells, 4 months before leukemic cells were found in her peripheral blood and the diagnosis of acute myelomonocytic leukemia was made by bone marrow aspiration. This case illustrates the difficulty in diagnosing leukemia cutis from examination of routine histologic sections and the importance of specialized marker studies in determining the cause of an atypical cellular infiltrate of the skin. It also illustrates how leukemia cutis can masquerade as a clinically benign-appearing cutaneous eruption in a seemingly healthy patient with normal blood parameters.
白细胞缺乏性白血病性皮肤浸润是一种罕见病症，患者在外周血中检测到白血病证据之前就已出现含有白血病细胞的皮肤病变。英文文献中仅记载了23例这种现象。我们描述了一名62岁女性，在其外周血中发现白血病细胞且通过骨髓穿刺诊断为急性粒单核细胞白血病4个月前，她出现了弥漫性、临床上看似良性的皮肤疹，组织学检查显示有非典型细胞浸润。该病例说明了通过常规组织学切片检查诊断白血病性皮肤浸润的困难，以及在确定皮肤非典型细胞浸润原因时进行特殊标记研究的重要性。它还说明了白血病性皮肤浸润如何在一名血液参数正常、看似健康的患者中伪装成临床上看似良性的皮肤疹。
