| Incidental chronic lymphocytic leukaemia in a biopsy of Merkel cell carcinoma. | |
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MedLine Citation:
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PMID: 19519600 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Paul J Craig; Jaime E Calonje; Mark Harries; Catherine M Stefanato |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of cutaneous pathology Volume: 36 ISSN: 1600-0560 ISO Abbreviation: J. Cutan. Pathol. Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-06-12 Completed Date: 2009-08-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0425124 Medline TA: J Cutan Pathol Country: Denmark |
Other Details:
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Languages: eng Pagination: 706-10 Citation Subset: IM |
Affiliation:
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Department of Dermatopathology, St John's Institute of Dermatology, Guys and St Thomas' NHS Foundation Trust, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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