Specific skin manifestations in acute leukemia with monocytic differentiation a morphologic and immunohistochemical study of 11 cases
✍ Scribed by Norbert Sepp; Thaddäus Radaszkiewicz; Chris J. L. M. Meijer; Josef Smolle; Helmut Seewann; Peter Fritsch; Helmut Kerl
- Publisher
- John Wiley and Sons
- Year
- 1993
- Tongue
- English
- Weight
- 874 KB
- Volume
- 71
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Background. Monocytic differentiation is present in the myelomonocytic (M4) and monocytic (M5) type of acute myeloblastic leukemia. Infiltration of the skin in acute myelomonocytic leukemia occurs in lo-ZO% of patients, the skin lesions occasionally being the first symptom, even preceding monocytosis.
Eleven patients with myelomonocytic (n = 2) and monocytic leukemia (n = 9) were studied who had skin manifestations.
Clinically, all patients showed disseminated papules or nodules that corresponded histologically to nodular or diffuse infiltrates of monocytoid cells, occasionally displaying a whorled pattern. The currently available antibodies for paraffin-embedded sections (lysozyme, elastase, leukocyte common antigen (CD45), MT1 (CD43), Leu-MI (CD15), LN2 (CD74), MB2, MB1 (CD45RA), LN1 (w75), Mac387, L26 (CD20), UCHLl (CDRO), MT2 (CD45RA), and KP-1 (CDSS)) and chloracetate-esterase are not more helpful in diagnosis than are the histologic findings. By contrast, the antibodies used on frozen sections (Leu4 (CD3), Leu-3a (CD4), BA1 (CD24), B4 (CD19), Leu-M5 (CDllc), Vim12 (CDllb), VimD5 (CD15), KiM6 (CDSS), KIM7 (CD68), My7 (CD13), and My9 (CD33) allow the definition of a reaction pattern that is diagnostic for acute myeloid leukemia with monocytic differentiation. Cancer 1993; 71:124-32.