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Generalized Leukaemia Cutis from a Small Cell Variant of T-cell Prolymphocytic Leukaemia Presenting with Exfoliative Dermatitis
T-cell prolymphocytic leukaemia (T-PLL) is a rare, aggressive neoplasm of mature T lymphocytes. The small cell variant occurs in approximately 20% of T-PLL patients. The skin findings of leukaemia consist of leukaemia-specific skin lesions, which are infiltrated by leukaemia cells, and non-specific lesions. The former type of lesion signifies leukaemia cutis. Leukaemia cutis presents clinically as tumours, nodules, or patches on the scalp, face and trunk. We report here an 82-year-old Korean male patient who presented with erythema, erosion, vesicles, and scales on his entire body with no clear underlying cause. He had been treated with oral retinoids, steroids, and phototherapy for the diagnoses of drug eruption, pityriasis rubra pilaris, and exfoliative dermatitis at other hospitals. We suspected a hidden malignancy and diagnosed small cell variant T-PLL through blood and bone marrow examination. A skin biopsy specimen showed dense infiltration of small lymphocytes in the dermis. Most of the atypical lymphocytes stained positively with CD markers such as CD2, CD3, CD4, CD5, CD7 and CD8, thereby confirming the presence of leukaemia cells. To our knowledge, this is the first case of generalized leukaemia cutis from small cell variant of T-PLL presenting with exfoliative dermatitis over the whole body.
Ki-Heon Jeong, Bark-Lynn Lew, Woo-Young Sim
Catovsky D, Ralfkiaer E, Muller-Hermelink HK. T-cell prolymphocytic leukaemia. In: Jaffe ES, Harris NL, Stein H, Vardiman JW, editors. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. World Health Organization Classification of Tumours. Lyon, France: IARC Press, 2001: p. 195–198.
Matutes E, Brito-Babapulle V, Swansbury J, Ellis J, Morilla R, Dearden C, et al. Clinical and laboratory features of 78 cases of T-prolymphocytic leukemia. Blood 1991; 78: 3269–3274.
Thorat KB, Gujral S, Kumar A, Nair CN. Small cell variant of T-cell prolymphocytic leukemia exhibiting suppressor phenotype. Leuk Lymphoma 2006; 47: 1711–1713.
Keating MJ, Cazin B, Coutré S, Birhiray R, Kovacsovics T, Langer W, et al. Campath-1H treatment of T-cell prolymphocytic leukemia in patients for whom at least one prior chemotherapy regimen has failed. J Clin Oncol 2002; 20: 205–213.
Foucar K. Mature T-cell leukemias including T-prolymphocytic leukemia, adult T-cell leukemia/lymphoma, and Sézary syndrome. Am J Clin Pathol 2007; 127: 496–510.
Herling M, Khoury JD, Washington LT, Duvic M, Keating MJ, Jones D. A systematic approach to diagnosis of mature T-cell leukemias reveals heterogeneity among WHO categories. Blood 2004; 104: 328–335.
Robak E, Robak T. Skin lesions in chronic lymphocytic leukemia. Leuk Lymphoma 2007; 48: 855–865.
Miyoshi I, Uemura Y, Sonobe H, Taguchi H. Leukemia cutis. Intern Med 2007; 46: 65–66.
Watson KM, Mufti G, Salisbury JR, du Vivier AW, Creamer D. Spectrum of clinical presentation, treatment and prognosis in a series of eight patients with leukaemia cutis. Clin Exp Dermatol 2006; 31: 218–221.
Mallett RB, Matutes E, Catovsky D, Maclennan K, Mortimer PS, Holden CA. Cutaneous infiltration in T-cell prolymphocytic leukaemia. Br J Dermatol 1995; 132: 263–266.
Magro CM, Morrison CD, Heerema N, Porcu P, Sroa N, Deng AC. T-cell prolymphocytic leukemia: an aggressive T-cell malignancy with frequent cutaneous tropism. J Am Acad Dermatol 2006; 55: 467–477.
Volk JR, Kjeldsberg CR, Eyre HJ, Marty J. T-cell prolymphocytic leukemia. Clinical and immunology characterization. Cancer 1983; 52: 2049–2054.
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Volume 89, Issue 5
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