Case Number : Case 1877 - 08 August - Dr Diwan Posted By: Guest

Hematological malignancy, leukemia cutis?

Hematolymphoid infiltrates for complete IHC. Can not predict anything from morphology actually. 

Lymphomatoid granulomatosis (for cpc of course!!!)

The infiltrate seems angiocentric, and some cells are larger (EBV+ B-cells) then others (reactive T-cells), but it's a lot difficult with these photos...

Leukemia cutis.  Patient has AML.  MPO is positive.

This dermal infiltrate is predominantly perivascular mononuclear cellular infiltrate with stands of single cells between the collagen bundles. There is subtle pallor of papillary dermis but no convincing oedema. MPO will stain the premature granulocytes and I wounder how this infiltrate is different from "Histiocytoid" Sweet's Syndrome? AML is one of well known Haematological malignancies associates with SS (besides MDS and others). The clinical context and sometimes only a period of observation can clarify this distinction. 

Iam grateful if any Dermatopathologist colleague can educate me if such distinction is possible on histology/IHC?

Classical SS is diffuse dense band like but predominant perivascular distribution can be seen (probably depending on the age and morphology of the lesion biopsied).

Thanks

Another feature seen in this slide is hyalinization of collagen. Is this seen only in this malignancy? Pubmed search for hyalinization of collagen by malignant cells shows no results