Leukaemias myeloic of the skin C92.7

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.11.2021

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Synonym(s)

AML

Definition
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Specific skin lesions in various subtypes of acute myeloid leukaemia (AML), chronic myeloid leukaemia (CML), chronic myelomonocytic leukaemia (CMML) S.a. leukemias of the skin.

Occurrence/Epidemiology
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Specific skin infiltrates may occur within the framework of the already diagnosed underlying disease (usually during a blast episode) or precede it by weeks or months.

Clinical features
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Integument: 0.5- 5.0 cm in size, usually sharply circumscribed, firm, blue- to brown-red, sometimes blue-grey to livid-red, easily necrotically disintegrating papules, plaques or nodules. Confluence of small foci results in plate-like, flat, pale, blue-gray to bluish-red, smooth or bumpy, firm plaques that may become hemorrhagic as a result of the frequently accompanying thrombocytopenia.

Mucous membrane (especially oral and pharyngeal cavity): Hemorrhages, reddish to purplish, nodular or squamous, moderately coarse infiltrates, sometimes overgrowing the teeth.

Only very rarely are tumor formations that acquire a greenish color due to intramural production of porphyrins and are therefore called chloroma.

Histology
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In all layers of the corium, often also in the subcutaneous tissue, cell dense, partly diffuse, partly nodular infiltrates of immature cells of the myeloid series (myelocytes, metamyelocytes, eosinophil metamyelocytes, segmented neutrophil granulocytes); in addition lymphocytes, mast cells and phagocytizing histiocytes. In myelosarcoma, medium to large pleomorphic cells of the granulocyte series and blasts predominate. Immunohistologically, strong positivity results when stained with myeloperoxidase (MOP), lysozyme and MT1 (CD 43).

Differential diagnosis
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Therapy
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Treatment of the underlying disease by oncologists.

Literature
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  1. Kaddu S et al (1999) Specific cutaneous infiltrates in patients with myelogenous leukemia: a clinicopathologic study of 26 patients with assessment of diagnostic criteria. J Am Acad Dermatol 40: 966-978
  2. Lane JE et al (2002) Cutaneous sclerosing extramedullary hematopoietic tumor in chronic myelogenous leukemia. J Cutan catheter 29: 608-612
  3. Mangla A et al (2015) Aleukaemic leukaemia cutis. Br J Haematol 170:4
  4. Pulido-Díaz N et al. (2015) Cutaneous manifestations of leukemia. Rev Med Inst Mex Seguro Soc 53 Suppl 1: 30-35

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Last updated on: 13.11.2021