Incidental chronic lymphocytic leukaemia in a biopsy of Merkel cell carcinoma

Journal of Cutaneous Pathology - Tập 36 Số 6 - Trang 706-710 - 2009
Paul Craig1, Jaime Eduardo Calonje1, Mark Harries2, Catherine M. Stefanato1
1Department of Dermatopathology, St John's Institute of Dermatology, Guys' and St Thomas' NHS Foundation Trust, London, UK
2Department of Oncology, Guys and St Thomas’ NHS Foundation Trust, London, UK

Tóm tắt

Chronic lymphocytic leukaemia (CLL) shows cutaneous involvement in 2% of cases. Merkel cell carcinoma (MCC) is a rare primary cutaneous epithelial neoplasm most commonly found in sun‐exposed sites in elderly male Caucasians. A 66‐year‐old man presented with a 2‐month history of a purple painless 2 cm tumor on the scalp. Excision biopsy revealed an incompletely excised MCC, and at the periphery of the MCC, a lymphocytic infiltrate interpreted as reactive. A re‐excision biopsy showed residual MCC as well as dense aggregates of small lymphocytes within and surrounding the MCC. Immunohistochemistry showed characteristic dot‐like cytoplasmic positivity for cytokeratin 20 in the MCC; the lymphocytic infiltrate was positive for CD5, CD20 and CD23, diagnostic of CLL. Subsequent staging revealed widespread lymphadenopathy, and lymph node biopsy showed CLL. Histologically, CLL and MCC are ‘round blue cell tumors’ and are therefore in the differential diagnoses of each other. Whenever there is a more prominent than expected infiltrate of small lymphocytes surrounding a skin lesion in an elderly patient, immunohistochemistry to rule out CLL is advised. This case adds to the literature suggesting an increased incidence of CLL and other neoplasms in patients with MCC and vice versa.

Từ khóa


Tài liệu tham khảo

10.1111/j.1600-0560.1996.tb01440.x

10.1097/00000478-199608000-00009

10.1200/JCO.2002.20.2.588

10.1111/j.0303-6987.2004.00149.x

10.1016/S0190-9622(97)70100-2

10.1002/1097-0142(19950701)76:1<26::AID-CNCR2820760105>3.0.CO;2-J

10.1034/j.1600-0560.2002.290303.x

10.1111/j.1365-2133.2004.05982.x

10.1111/j.1600-0560.1998.tb01709.x

10.1038/bjc.1996.642

10.1046/j.1524-4725.2003.29034.x

10.1016/j.jaad.2007.11.020

10.1097/00000658-198802000-00015

10.1016/S0002-9610(97)00193-1

Miller RW, 1999, Merkel cell carcinoma and melanoma: etiological similarities and differences, Cancer Epidemiol Biomarkers Prev, 8, 153

10.1097/00000478-199206000-00006

10.1111/j.0303-6987.2005.00270.x

10.1016/S0190-9622(97)70110-5

10.1002/dc.20616

10.1136/jcp.56.12.970

10.1097/01.coc.0000037108.86294.5E

10.1186/1471-2407-5-106

10.1136/bjo.87.2.240

10.1046/j.1365-2133.2001.03996.x

10.1046/j.1365-2133.2002.49859.x

10.1046/j.1365-2133.2000.03370.x

10.1007/BF01676233

10.3109/10428199609052438

Quaglino D, 1997, Association between chronic lymphocytic leukaemia and secondary tumours: unusual occurrence of a neuroendocrine (Merkell cell) carcinoma, Eur Rev Med Pharmacol Sci, 1, 11

10.1080/10428190500057759

Brenner B, 2001, Cancer second neoplasms in patients with Merkel cell carcinoma, 91, 1358

10.1016/S0001-7310(06)73396-8

10.1111/j.1445-2197.2007.04127_32.x

10.1001/jama.1975.03250030023012

10.1136/bmj.310.6993.1491

10.1016/j.jaad.2005.08.055

Thông tin
Thông tin xuất bản

Journal of Cutaneous Pathology

Tập 36 Số 6

706-710

Thông tin tác giả