Eruptive Juvenile Xanthogranuloma Associated with Relapsing Acute Lymphoblastic Leukemia

Aparicio, Gloria; Mollet, Jordi; Bartralot, R.; Bodet, D.; Heras, Cristina de las; Bassas, P.; Virós, Amaya; García‐Patos, Vicente

doi:10.1111/j.1525-1470.2008.00721.x

Cited by 18 publications

(9 citation statements)

References 5 publications

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“…According to some authors, the association is much higher in the presence of NF1 [32], but others have disputed the strength of this association [33]. Aparicio and colleagues [34] described a child with B-cell ALL in relapse who developed cutaneous JXG over much of the body. No NF1 features were present.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic Features of Histiocytic Lesions following ALL, with a Review of the Literature

Castro

Blázquez

Boyd³

et al. 2010

Pediatr Dev Pathol

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We describe the clinicopathologic features of 15 patients who had histiocytic lesions that followed acute lymphoblastic leukemia (ALL). Twenty-one separate histiocytic lesions were evaluated that covered a wide spectrum, some conforming to the usual categories of juvenile xanthogranulomas (5), Langerhans' cell histiocytosis (1), Langerhans' cell sarcoma (4), Rosai-Dorfman disease (1), and histiocytic sarcoma (4). Most were atypical for the category by histology, phenotype, or abnormally high turnover rate. Seven low-grade lesions defied easy categorization and were characterized only as "atypical histiocytic lesion" following ALL. For those evaluated, the molecular signature of the prior leukemia was present in the histiocytic lesion. In 3 of 15 patients, the leukemia and histiocytic lesion shared immunoglobulin H or monoclonal TCR gene rearrangements and, in 4 of 15 patients, clonal identity was documented by fluorescence in situ hybridization. Four patients died of progressive disease, 3 of whom had histiocytic sarcoma and 1 who had an atypical lesion. One patient died of recurrent ALL. The other 10 patients are alive, 7 after recurrences and treatment with surgery and/or chemotherapy. The post-ALL lesions are more aggressive than their native counterparts, but despite the demonstration of the presence of the leukemia signature in 7 of 15 patients, the prognosis is generally favorable, except for patients with histiocytic sarcoma. It remains unclear whether the histiocytic lesions arise as a line from the original ALL or whether transdifferentiation is involved.

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Section: Discussionmentioning

confidence: 99%

Clinicopathologic Features of Histiocytic Lesions following ALL, with a Review of the Literature

Castro

Blázquez

Boyd³

et al. 2010

Pediatr Dev Pathol

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“…The excess gamma globulins seen in leukaemia have been implicated in the stimulation of histiocytic proliferation and JXG formation. 11 The triple association of JXG, NF-1 and juvenile chronic myelogenous leukaemia (JCML) remains debatable. 1 One study reported a 20 to 32-fold increased risk of developing JCML in children with concomitant NF and JXG in comparison to NF-1 alone.…”

Section: Discussionmentioning

confidence: 99%

Juvenile xanthogranuloma: Challenges in complicated cases

Sivapirabu¹,

Sugo²,

Wargon³

2011

Australasian Journal of Dermatology

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Juvenile xanthogranuloma (JXG) is one of the most common forms of non-Langerhans cell histiocytosis in children. Although it usually presents as a self-limited skin lesion with typical histopathology, JXG can be challenging to diagnose due to an atypical initial presentation with corresponding variable histopathology for different stages of development. We present challenging cases of JXG from Sydney Children's Hospital, collected over 10 years - two with multisystem involvement and concomitant urticaria, one associated with neurofibromatosis, and one case of giant JXG with an initial histopathological challenge. Although JXG has been reported with urticaria pigmentosa, in two of our cases persistent urticaria, in association with JXG is discussed.

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“…In BCH, the lesions have a roughly symmetrical distribution, mainly in the cephalocaudal progression; lesions do not appear in the palmar and plantar regions , and nose and scalp lesions are not common, as our cases showed. In disseminated JXG, asymmetrically distributed, scattered lesions appear over the entire body, including the palmar and plantar regions, and with typical nose and scalp involvement . Moreover, extracutaneous involvement, particularly eye manifestations, can be seen in JXG .…”

Section: Discussionmentioning

confidence: 99%