Cutaneous presentation of chronic lymphocytic leukemia as unique extramedullar involvement in a patient with normal peripheral blood lymphocyte count (monoclonal B-cell lymphocytosis)

J Cutan Pathol. 2013 Aug;40(8):740-4. doi: 10.1111/cup.12167. Epub 2013 May 3.

Abstract

Skin infiltration by chronic lymphocytic leukemia (CLL) is very rare and almost all reported cases occur in advanced stage. We report a patient with no relevant past medical history who presented with cutaneous erythematous plaques. A punch biopsy showed typical CLL morphologic and immunophenotypic features. Subsequent studies revealed a normal lymphocyte count in peripheral blood, and there was no evidence of lymphadenopathy or organomegaly. Flow cytometry demonstrated a clonal B-cell population both in the bone marrow and peripheral blood (1.60 × 10(9)/l) with a CLL phenotype, but it did not fulfill required criteria for CLL diagnosis. Without cutaneous involvement, this case should be classified as monoclonal B-cell lymphocytosis.

Keywords: cutaneous lymphoma; hematopathology; molecular pathology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • B-Lymphocytes* / metabolism
  • B-Lymphocytes* / pathology
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / blood
  • Leukemia, Lymphocytic, Chronic, B-Cell* / pathology
  • Lymphocyte Count
  • Lymphocytosis* / blood
  • Lymphocytosis* / pathology
  • Male
  • Skin Neoplasms* / blood
  • Skin Neoplasms* / pathology