Cutaneous involvement by T-cell prolymphocytic leukemia presenting as livedoid vasculopathy

J Cutan Pathol. 2021 Jul;48(7):975-979. doi: 10.1111/cup.14023. Epub 2021 Apr 20.

Abstract

T-cell prolymphocytic leukemia (T-PLL) is a rare, aggressive neoplasm derived from post-thymic T-cells. Patients are typically middle aged with a slight male predominance who present with a high white blood cell count, hepatosplenomegaly, lymphadenopathy, and other symptoms typically associated with leukemia. Although cutaneous involvement has been reported in up to 30% of cases of T-PLL, to our knowledge, none have presented with a presentation resembling livedoid vasculopathy. In the correct clinical context, an underlying hematolymphoid neoplasm should be included in the differential diagnosis of a patient presenting with livedoid vasculopathy.

Keywords: T-cell prolymphocytic leukemia; alemtuzumab; livedoid vasculopathy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Alemtuzumab / therapeutic use
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Antineoplastic Agents, Immunological / therapeutic use
  • Bendamustine Hydrochloride / administration & dosage
  • Bendamustine Hydrochloride / therapeutic use
  • Biopsy / methods
  • Diagnosis, Differential
  • Disease Progression
  • Exanthema / etiology
  • Exanthema / pathology
  • Extremities / pathology
  • Fatal Outcome
  • Humans
  • Hyperpigmentation / diagnosis
  • Hyperpigmentation / etiology*
  • Immunohistochemistry / methods
  • Leukemia, Prolymphocytic, T-Cell / diagnosis*
  • Leukemia, Prolymphocytic, T-Cell / drug therapy
  • Leukemia, Prolymphocytic, T-Cell / metabolism*
  • Male
  • Skin Neoplasms / pathology*
  • Torso / pathology
  • Vascular Diseases / diagnosis*
  • Vascular Diseases / pathology

Substances

  • Antineoplastic Agents, Alkylating
  • Antineoplastic Agents, Immunological
  • Alemtuzumab
  • Bendamustine Hydrochloride