Acute Myelomonocytic Leukemia Cutis Presenting as a Conjunctival Lesion

Lee, David A.; Su, W.P. Daniel

doi:10.1111/j.1365-4362.1985.tb05803.x

Cited by 13 publications

(7 citation statements)

References 5 publications

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“…[8][9][10] Leukemic infiltration of the conjunctiva is rare but does occur to present the same clinical picture as lymphoma. [11][12][13][14][15] In the older literature, three patients have been described in separate case reports to develop multiple skin lesions and a conjunctival lesion in the course of acute myelomonocytic leukemia. [11][12][13] The manifestations in these three patients were similar to those in the present patient, and thus, might have been diagnosed as BPDCN using the current criteria.…”

Section: Fig 4 Whole-body 2-[mentioning

confidence: 99%

“…5 Other less common types of primary lymphoma in the conjunctiva, which have been reported so far, include T-cell lymphoma 6 and Burkitt lymphoma. 7 Benign lymphoid hyperplasia [8][9][10] and leukemic infiltration [11][12][13][14][15] also manifest as conjunctival masses. All conjunctival lesions, including lymphoma, leukemic infiltration, and benign lymphoid hyperplasia, present the same clinical feature called salmon-pink lesions.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Conjunctival Lesions in Blastic Plasmacytoid Dendritic Cell Neoplasm

Matsuo

Ichimura

Tanaka

et al. 2011

J Clin Exp Hematopathol

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The purpose of this study is to report on a patient who developed conjunctival lesions of blastic plasmacytoid dendritic cell neoplasm (BPDCN) after radiation to skin lesions of the same pathological type. A 79-year-old man developed salmon-pink lesions in the lower fornix of the conjunctiva of both eyes and biopsy revealed BPDCN. One and a half years previously, he noticed an erythematous plaque with a 30-mm diameter, which later became multiple, on the left chest, and the biopsy revealed BPDCN. The bone marrow was negative for CD56-positive cells, but fluorescence-activated cell sorting analysis of peripheral blood cells revealed a group of cells positive for CD4 and CD56, or CD4 and CD123. The monocyte fraction, in an increased percentage of white blood cell counts, did contain atypical cells positive for the three markers. Whole-body 2-[18 F]fluoro-2-deoxy-D-glucose positron emission tomography combined with computed tomography demonstrated no abnormal uptake lesions. He received 30 Gy of radiation to the chest lesions, and later, the same dose of radiation to novel skin lesions on the back, waist, and chest, and also to pharyngeal lesions. In conclusion, the conjunctiva could be involved with BPDCN and pathological differential diagnosis by biopsy is mandatory to establish the correct diagnosis. 〔J Clin Exp Hematopathol 51(1) : 49-55, 2011〕

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Section: Fig 4 Whole-body 2-[mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bilateral Conjunctival Lesions in Blastic Plasmacytoid Dendritic Cell Neoplasm

Matsuo

Ichimura

Tanaka

et al. 2011

J Clin Exp Hematopathol

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“…Em estudo retrospectivo, foi encon- trado 4% (14/384) de algum grau de infiltração leucêmica, porém nenhum dos casos revistos eram de leucemias de linhagem mieloblástica como o caso descrito 2,3,8 .…”

Section: Discussionunclassified

“…São feitas considerações a respeito das manifestações sistêmicas e oftalmológicas e atualização desta doença. (1) Residente do Terceiro ano do Departamento de Oftalmologia da EPM-UNIFESP (2) Doutora em Oftalmologia do Setor de Doenças Externas do Departamento de Oftalmologia da EPM-UNIFESP (3) Médica voluntária do Departamento de Oftalmologia da EPM-UNIFESP (4) Professor Assistente do Departamento de Anatomia Patológica da EPM-UNIFESP (5) Pós-graduanda da Disciplina de Hematologia do Departamento de Clínica Médica da EPM-UNIFESP (6) Ciro Massaiuki Komagome (1 ) Luciene Barbosa de Sousa (2 ) Maria do Carmo Pinheiro (3 ) Moacyr Rigueiro (4 ) Isabel Cristina Proença Gil (5 ) Denise de Freitas (6 ) RESUMO Palavras-chave: Leucemia mielóide; Infiltração; Conjuntiva; Cloroma; Sarcoma granulocítico.…”

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Infiltração conjuntival como primeira manifestação de leucemia mielóide aguda: relato de caso

Komagome¹,

Sousa²,

Pinheiro³

et al. 2000

Arq. Bras. Oftalmol.

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Os autores descrevem o caso de paciente portadora de leucemia mielóide aguda que apresentou como primeira manifestação da doença, infiltração leucêmica conjuntival. São feitas considerações a respeito das manifestações sistêmicas e oftalmológicas e atualização desta doença. Conjunctival infiltration as INTRODUÇÃOAs leucemias são neoplasias derivadas de células hematopoéticas, que proliferam a princípio na medula óssea, antes de se disseminar para o sangue periférico, baço, linfonodos e por fim, outros tecidos 1 .A classificação das leucemias baseia-se, em grande parte, na célula de origem (linfóide ou mielóide), bem como na velocidade de seu curso clínico (aguda ou crônica). A leucemia aguda caracteriza-se pela proliferação clonal de células hemapoéticas imaturas. De acordo com a linhagem, pode ser dividida em leucemia mielóide aguda (mieloblastos ou promieló-citos) ou leucemia linfocítica aguda (linfoblastos) 1 .As manifestações clínicas da leucemia mielóide aguda se caracterizam por quadro de anemia, palidez, fatigabilidade fácil e dispnéia aos pequenos esforços. O sangramento está relacionado ao quadro de trombocitopenia, podendo estar associado com aparecimento de petéquias e equimoses. A infecção é uma complicação praticamente universal da leucemia aguda e é inversamente proporcional ao número de neutrófilos circulantes 1 .Pode-se verificar o desenvolvimento de massas de células leucêmicas em tecidos moles em qualquer localização, sendo que algumas vezes a leucemia extramedular com acometimento ocular pode preceder o comprometimento detectável da medula óssea 3 .O acometimento de tecidos oculares é raro tendo a retina e coróide como sítios mais comuns. Alterações retinianas ocorrem em 30% a 90% dos casos de leucemia 3,4 . Dilatações e aumento de tortuosidade dos vasos e hemorragias retinianas são os achados mais comuns. Porém, pode-se observar exsudatos algodonosos e manchas acinzentadas indicando infiltração leucêmica 3 .A coróide é um dos tecidos oculares mais envolvidos por infiltração leucêmica em estudos histopatológicos, variando de 65% a 85%. Os achados mais comuns são aumento da espessura, hiperplasia e hipertrofia dos tecidos uveais 3 . RELATOS CURTOS

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“…13 The conjunctival lesions could also be caused by benign lymphoid hyperplasia [14][15][16] and leukemic infiltration. [17][18][19][20][21] In this study, we report a patient who developed bilateral conjunctival lesions in the course of chronic lymphocytic leukemia as an initial diagnosis. Conjunctival biopsy demonstrated mantle cell lymphoma, which was also supported by immunohistochemical restaining of the previous bone marrow biopsy specimen.…”

Section: Introductionmentioning

confidence: 99%

Mantle Cell Lymphoma Diagnosed by Conjunctival Salmon-Pink Lesion Biopsy

Matsuo

Ichimura

Kubonishi

2014

J Clin Exp Hematopathol

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Conjunctival lesions are rarely seen in mantle cell lymphoma. Here, we report a patient who developed bilateral conjunctival lesions in the course of chronic lymphocytic leukemia as an initial diagnosis, resulting in the final diagnosis of mantle cell lymphoma by conjunctival biopsy. A 66-year-old man developed conjunctival salmon-pink lesions on both sides in the 1.5-year course of chronic lymphocytic leukemia. He also had irregularly shaped masses with low tissue density in the orbital apex on both sides. Bilateral conjunctival biopsy showed subepithelial infiltration with lymphoid cells, positive for CD20, CD5, and cyclin D1, but negative for CD3, CD10, and CD23. Immunohistochemical restaining of the previous bone marrow biopsy specimen demonstrated lymphoid cells positive for cyclin D1, confirming the diagnosis of mantle cell lymphoma with leukemic presentation. As the case presenting stage IV lymphoma with systemic lymphadenopathy, he underwent 3 courses of combination chemotherapy with fludarabine and cyclophosphamide, and then 6 courses of bendamustine with rituximab, leading to complete remission for the following 3 years. In conclusion, mantle cell lymphoma should be included in the differential diagnosis of conjunctival salmon-pink lesions.

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Acute Myelomonocytic Leukemia Cutis Presenting as a Conjunctival Lesion

Cited by 13 publications

References 5 publications

Bilateral Conjunctival Lesions in Blastic Plasmacytoid Dendritic Cell Neoplasm

Bilateral Conjunctival Lesions in Blastic Plasmacytoid Dendritic Cell Neoplasm

Infiltração conjuntival como primeira manifestação de leucemia mielóide aguda: relato de caso

Mantle Cell Lymphoma Diagnosed by Conjunctival Salmon-Pink Lesion Biopsy

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