Document Detail


Incidental chronic lymphocytic leukaemia in a biopsy of Merkel cell carcinoma.
MedLine Citation:
PMID:  19519600     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Paul J Craig; Jaime E Calonje; Mark Harries; Catherine M Stefanato
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cutaneous pathology     Volume:  36     ISSN:  1600-0560     ISO Abbreviation:  J. Cutan. Pathol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-12     Completed Date:  2009-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0425124     Medline TA:  J Cutan Pathol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  706-10     Citation Subset:  IM    
Affiliation:
Department of Dermatopathology, St John's Institute of Dermatology, Guys and St Thomas' NHS Foundation Trust, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Carcinoma, Merkel Cell / metabolism,  pathology*,  therapy
Combined Modality Therapy
Humans
Immunohistochemistry
Incidental Findings
Leukemia, Lymphocytic, Chronic, B-Cell / metabolism,  pathology*,  therapy
Male
Neoplasms, Multiple Primary / metabolism,  pathology*,  therapy
Radiotherapy
Scalp / pathology
Skin Neoplasms / metabolism,  pathology*,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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