A case of leukemia cutis at the site of a prior catheter insertion

Abstract

Leukemia cutis is the cutaneous involvement of leukemic neoplastic cells. It is an uncommon feature of systemic leukemia, and is associated with a poor prognosis. A 20-year-old man presented with a solitary, 2 cm domeshaped, firm, erythematous nodule on the right medial malleolus that was present for 3 months. The patient had a history of venous catheter insertion at the right medial malleolus area 3 months previously. The history was significant for acute lymphoblastic leukemia (ALL) for 4 years; an allogenic bone marrow transplantation was performed 3 years earlier. The histologc examination of the lesion revealed diffuse infiltration of leukemic cells in the dermis and subcutis. Herein we report a case of leukemia cutis at the site of a prior catheter insertion in a patient with ALL.

Keywords: Acute lymphocytic leukemia; Leukemia cutis; Site of catheter insertion.

Fig. 1

Asymptomtic, solitary, domeshaped, firm, erythematous nodule on the right medial malleolus area.

Fig. 2

(A) The skin biopsy specimen of the nodule showed diffuse infiltration in the dermis and subcutis (H&E, ×40). (B) The infiltrated cells were small, polymorphic, atypical cells having hyperchromatic nuclei (H&E, ×400).

Fig. 3

Immunohistochemical features. The infiltrated cells were positive for (A) TdT (×200) and (B) CD79a (×200), and negative for (C) CD3 (×200) and (D) CD20 (×200).