PMC7233898_01
Multiple erythematous nodules of aleukemic leukemia cutis on the patient's (A) chest, (B) left forearm, (C) left upper arm, and (D) left inner arm.
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A 40-year-old male patient presented to our clinic in January of 2017 with a 6-month history of dozens of painful nodules throughout his body (Figure 1), and progressive severe pain in his abdomen and joints.
(A) Medium power image highlighting the lack of significant atypia in the small lymphocytes. No mitoses or apoptoses are present. These lymphocytes could be mistaken as a normal reactive perivascular infiltrate. (B) Low power image showing a mild to moderate lymphocytic perivascular infiltrate with minimal cytologic atypia. This is a common pattern for reactive lymphocytic infiltrates.
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The lymphoid cells were small and showed minimal cytologic atypia (Figure 2).
Immunohistochemical stains highlighting the perivascular malignant cells: (a) CD43, (b) MPO, and (c) CD68.
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However, because of the cellularity of the infiltrate and the clinical history of persistent lesions, additional immunohistochemical stains were performed to further investigate the nature of the dermal cells (Figure 3).