Unusual cutaneous manifestations of B-cell chronic lymphocytic leukemia

Plaza, Jose A.; Comfere, Nneka I.; Gibson, Lawrence E.; Colgan, Michael; Davis, Dawn M.; Pittelkow, Mark R.; Colgan, Joseph P.

doi:10.1016/j.jaad.2008.12.047

Cited by 41 publications

(49 citation statements)

References 20 publications

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“…In particular, only 3 publications have so far reported such a localization in CLL patients 8–10. Systemic therapy induced local partial remission in our patient demonstrating sensitiveness of the lesion even after multiple treatments.…”

Section: Discussionmentioning

confidence: 49%

An Urologic Face of Chronic Lymphocytic Leukemia:Sequential Prostatic and Penis Localization

D’Arena

Guariglia

Villani

et al. 2013

Mediterr J Hematol Infect Dis

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We report a patient with chronic lymphocytic leukemia (CLL) in whom a leukemic involvement of prostate and penis occurred in the advanced phase of his disease. Obstructive urinary symptoms were indicative of prostatic CLL infiltration, followed by the occurrence of an ulcerative lesion on the glans. Histologic examination confirmed the neoplastic B-cell infiltration. Both localizations responded to conventional treatments. A review of the literature confirms that leukemic involvement of the genito-urinary system is uncommon in CLL patients. However, it should be considered in CLL patients with urologic symptoms and a long history of the disease.

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Section: Discussionmentioning

confidence: 49%

An Urologic Face of Chronic Lymphocytic Leukemia:Sequential Prostatic and Penis Localization

D’Arena

Guariglia

Villani

et al. 2013

Mediterr J Hematol Infect Dis

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“…Specific cutaneous involvement by B-CLL has a plethora of clinicopathological manifestations. 1,8 The commonest presentation is with multiple patches. [9][10][11][12] An unusual but well-documented presentation is the occurrence of specific B-CLL infiltrates in the vicinity of epithelial and nonepithelial lesions, including squamous cell carcinoma, keratoacanthoma, melanoma, Merkel cell carcinoma, dermatofibroma to name but a few.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Borreliosis With a T-Cell–Rich Infiltrate and Simultaneous Involvement by B-Cell Chronic Lymphocytic Leukemia With t(14;18)(q32;q21)

Kempf¹,

Kazakov

Hübscher

et al. 2015

The American Journal of Dermatopathology

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: Pseudolymphomatous infiltrates in Borrelia infection of the skin most commonly manifest with dense B-cell infiltrates and plasma cells. Cutaneous infiltrates of B-cell chronic lymphocytic leukemia (B-CLL) may accumulate at sites of infection, including Borrelia infection. We report an unusual constellation in a patient with synchronously diagnosed B-CLL and Borrelia infection of skin presenting with a dense dermal T-cell-rich infiltrate masking specific leukemic infiltrates of neoplastic B cells in the context of B-CLL harboring t(14;18)(q32;q21). Specific cutaneous involvement by B-CLL was confirmed by the detection of t(14;18)(q32;q21) (BCL2-IGH) using FISH in neoplastic B cells within the skin infiltrates. Borrelia burgdorferi (sensu lato) DNA detected by nested polymerase chain reaction in the skin biopsy and serological findings proved Borrelia infection. Complete resolution of the cutaneous infiltrates was observed after antibiotic treatment. This case demonstrates that Borrelia infection of the skin may present with dense T-cell-rich infiltrates mimicking cutaneous T-cell lymphoma and masking the synchronous presence of neoplastic B cells in the context of B-CLL.

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“…29 They can seem similar to other types of B-cell lymphomas to pseudolymphoma 29 or, unusually, they can mimic inflammatory conditions. 30 Although the infiltrate accompanying an epithelial neoplasm may not constitute a diagnostic dilemma, lesions similar in clinical appearance to other types of low grade B-cell lymphomas can potentially be challenging.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Analysis of Cutaneous Marginal Zone Lymphoma and Cutaneous Chronic Lymphocytic Leukemia

Levin

Mirzamani²,

Zwerner³

et al. 2012

The American Journal of Dermatopathology

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The morphologic distinction between cutaneous marginal zone lymphoma (CMZL) and secondary cutaneous involvement by B-cell chronic lymphocytic leukemia (B-CLL) can be difficult. Both entities can show very similar architectural patterns of involvement in the skin and not uncommonly, the skin can be the first site of presentation of B-CLL in the elderly. We reviewed biopsies of 13 patients with cutaneous B-CLL and 14 patients with CMZL to compare their histologic and immunohistochemical features. CMZL and cutaneous B-CLL both predominantly exhibited a nodular pattern of skin involvement (9 of 13 B-CLL, 9 of 14 CMZL) with a minority of cases demonstrating a diffuse pattern (4 of 13 B-CLL, 4 of 14 CMZL). Although reactive germinal centers (12 of 14 cases) and plasma cells (10 of 14 cases) were seen more often in CMZL, plasma cells were also observed in cases of B-CLL (4 of 13). The lesional cells of B-CLL expressed CD79, CD5, CD23, and CD43, although CMZL did not express CD5 or CD43. Although we noted light chain restriction in 13 of 14 cases of CMZL cases, we also observed light chain restriction in 4 of 13 cases of B-CLL. Our results indicate that CMZL and B-CLL can be morphologically similar and both may show light chain restriction. Complete immunophenotyping is necessary to ensure that all cases are correctly classified.

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Unusual cutaneous manifestations of B-cell chronic lymphocytic leukemia

Cited by 41 publications

References 20 publications

An Urologic Face of Chronic Lymphocytic Leukemia:Sequential Prostatic and Penis Localization

An Urologic Face of Chronic Lymphocytic Leukemia:Sequential Prostatic and Penis Localization

Cutaneous Borreliosis With a T-Cell–Rich Infiltrate and Simultaneous Involvement by B-Cell Chronic Lymphocytic Leukemia With t(14;18)(q32;q21)

A Comparative Analysis of Cutaneous Marginal Zone Lymphoma and Cutaneous Chronic Lymphocytic Leukemia

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