PMC7673920_01
Erythematous, round, well-grouped plaques located at the rear right costal arch. A biopsy of the skin lesions was performed and reported as compatible with leukemia cutis.
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fig1
At diagnosis, a physical examination revealed splenomegaly of 6 cm (splenomegaly was confirmed by abdominal ultrasound) and erythematous round well-defined grouped, not itchy, plaques located at the rear right costal arch (Figure 1).
Flow cytometry at diagnosis showed 33% of blasts distributed in 3 populations. 1st population, myeloid without differentiation (15%), in red: CD34++, CD117 +, HLA-DR +, CD45 + d, CD13+, CD64 -, CD35-/+ d, CD36-, CD33 +, CD71-/ +, CD105 + d, CD7-/ +, CD15-/ +, CD22-, CD38 +, CD123 +, CD4+d, and cMPO-. 2nd population, dendritic (13%), in blue: CD34+d, CD117-/+, HLA-DR++, CD45+d, CD13 +, CD64-/ +, CD35-, CD36-/ +, CD33++, CD71-/+, CD105 + d, CD7-/+, CD15-/+, CD22-, CD38 +, CD123++, CD4 + d, and cMPO-/ +. 3rd population, myeloid (5%), in yellow: CD34 + d, CD117 + d, HLA-DR-/+, CD45 + d, CD13 +, CD64-, CD35-, CD36-, CD33-, CD71-, CD105-, CD7-, CD15-, CD22 +, CD38-, CD123-, CD4-/+d, and cMPO-. Blasts were negative for CD10, CD16, CD11b, CD14, IREM-2, nTdT, CD56, CD19, 7.1, CD42, CD61, CD203c, cCD79a, cCD3, and CD3.
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fig2
Flow cytometry showed 33% blasts distributed in 3 populations (Figure 2): 1st, myeloid without differentiation (15%); 2nd, dendritic (13%); and 3rd, myeloid (5%).
Chest X-ray showing a triangular consolidation in the right superior lobule.
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fig3
The chest X-ray was compatible with this (Figure 3) and with a positive galactomannan in the bronchoalveolar lavage, he was treated with oral voriconazole 200 mg/12 h.