PMC7155858_01
Diffuse macular and erythematous lesions scattered on chest and abdomen (left), and back (right).
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F1
Her examination revealed diffuse erythematous and purpuric lesions overlying her face predominantly (cheeks bilaterally, eyelids, and forehead) with additional erythematous lesions scattered across her chest, back, abdomen, and legs (Fig. 1).
Bone marrow aspiration results: Wright-Giemsa staining (magnification, x 1,000).
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F2
Patient underwent bone marrow (BM) aspiration (Fig. 2) and biopsy (Fig. 3).
Flow cytometric immunophenotyping. Side scatter (SS) by CD45 flow cytometric profile of the blastic plasmacytoid dendritic cell neoplasm blast gate (red), demonstrating expression of CD4, CD56, CD123 and HLA-DR. HLA-DR: human leukocyte antigen-DR.
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F4
Flow cytometry (Fig. 4) revealed 57% medium to large abnormal CD45(dim+) cells within the nuclear cell gate with atypical cells positive for CD45 (slightly dim+), CD4 (dim+), CD13 (-), CD15(-), CD33(+), CD34(-), CD36 (partial+), CD38 (partial+), CD117 (variably+), HLADR(+), CD14(-), CD64(-), CD56(+), and CD123(+) which was compatible with BPDCN.