Jenei A, Tzankov A. Diagnostic approach to leukemia cutis : A differential diagnostic step-by-step algorithm.
Am J Clin Pathol 2024:aqae133. [PMID:
39422152 DOI:
10.1093/ajcp/aqae133]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 09/15/2024] [Indexed: 10/19/2024] Open
Abstract
OBJECTIVES
Leukemia cutis is a conflicting term to describe neoplastic hematopoietic infiltrates in the skin. Cutaneous myeloid or lymphoid proliferations often present a serious differential diagnostic challenge for pathologists.
METHODS
This review aims to outline the confusion associated with the term leukemia cutis and discuss in detail the foremost common differential diagnoses in daily practice. The review is based on a summary of the relevant literature as well as on the authors' experience.
RESULTS
It addresses precursor cell myeloid and lymphoid tumors that are strictly considered true leukemia cutis but also more mature neoplasms, including some recently described mature extramedullary myeloid proliferations. Finally, a practical, comprehensive stepwise approach combining traditional immunohistochemical marker panels, novel lineage- or mutational-specific markers, and other ancillary tests is suggested to reach an entity-specific diagnosis.
CONCLUSION
The proper combination of ancillary techniques can help the pathologist to provide an accurate diagnosis of these challenging skin lesions.
Collapse