皮肤白血病的临床病理相关性

Clinicopathologic correlations in leukemia cutis.

作者信息

Su W P, Buechner S A, Li C Y

出版信息

J Am Acad Dermatol. 1984 Jul;11(1):121-8. doi: 10.1016/s0190-9622(84)70145-9.

Abstract

This clinicopathologic study involved 42 cases of leukemia cutis: 3 of acute lymphocytic leukemia (ALL), 16 of chronic lymphocytic leukemia (CLL), 12 of acute granulocytic leukemia (AGL), 3 of chronic granulocytic leukemia (CGL), 5 of acute monocytic leukemia (AML), and 3 of acute myelomonocytic leukemia (AMML). The clinical appearance of leukemia cutis included papules, macules, plaques, nodules, ecchymoses, palpable purpura, and ulcerative lesions, and these were seen in all types of leukemias. Gingival hypertrophy was seen only in AML or AMML, and erythroderma and bullous lesions of leukemic infiltration were observed only in CLL. Cutaneous leukemic lesions may be concomitant with or preceding the diagnosis of systemic leukemia. Therefore, skin biopsy may be helpful in detecting the leukemia and may facilitate the work-up. Leukemia cutis probably is a dissemination of systemic leukemia to the skin, and the demonstration of leukemia in skin is associated with a very poor prognosis.

摘要

本临床病理研究纳入了42例皮肤白血病患者：其中急性淋巴细胞白血病（ALL）3例，慢性淋巴细胞白血病（CLL）16例，急性粒细胞白血病（AGL）12例，慢性粒细胞白血病（CGL）3例，急性单核细胞白血病（AML）5例，急性粒单核细胞白血病（AMML）3例。皮肤白血病的临床表现包括丘疹、斑疹、斑块、结节、瘀斑、可触及的紫癜及溃疡性病变，所有类型白血病均可见这些表现。牙龈增生仅见于AML或AMML，红皮病及白血病浸润性大疱性病变仅见于CLL。皮肤白血病病变可先于或伴随系统性白血病的诊断出现。因此，皮肤活检有助于白血病的检测并便于进一步检查。皮肤白血病可能是系统性白血病向皮肤的播散，皮肤中白血病的出现提示预后极差。