All, skin manifestations - Altmeyers Encyclopedia

Synonym(s)

Acute lymphatic leukemia; lymphoblastic leukemia; lymphoblastic lymphosarcoma; malignant lymphoma with small non cleaved follicle center cells; Paramyeloblastic leukemia; Stem cell leukemia

Definition
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Lymphoma of high malignancy, which can immunologically show B (B-LBL), or T cells (T-LBL) Specific skin lesions are rare.

Manifestation
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Especially occurring in children.

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Dermatology

Node

Circumscribed, fixed, hemispherical or even asymmetrically configured substance propagation (nodes > 1.0...

Clinical features
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Solitary, but also multiple nodes of different sizes, often ulcerated.

Histology
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Regardless of their provenance (B or T cells) similar histological pattern: Dense, diffuse, monomorphic infiltrate in dermis and subcutis. Sometimes starry sky-like pattern (starry sky). Cytomorphologically, medium or large cell lymphoblasts are found, with round or angular nuclei with irregularly distributed chromatin, usually narrow cytoplasmic border, interspersed with large macrophages.

Immunohistology:

B-LBL: positive for: CD20, CD10, CD43, CD34.

T-LBL: positive for: CD1a, CD3, CD43; negative for B-cell markers

Differential diagnosis
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Myelomonocytic leukemias; mantle cell lymphoma; Merkel cell tumor;
skin metastases of a small cell bronchial carcinoma.

Literature
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Kaddu S, Cerroni L, Kerl H (2003) Leukemias of the skin. In: Kerl H et al (ed.) Histopathology of the skin. Springer publishing house, Berlin Heidelberg New York, S. 917-919