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Differenzialdiagnose spezifischer Hautinfiltrate bei chronischer myelomonozytärer Leukämie

Differential diagnostic specific skin infiltrates in chronic myelomonocytic leukemia

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Zusammenfassung

Ein 72-jähriger Patient stellte sich mit multiplen erythematösen Plaques an Unterarmen, Unterschenkeln und Füßen vor. Bei dem Patienten bestanden eine rheumatoide Arthritis und eine begleitende interstitielle granulomatöse Dermatitis unter Therapie mit Tocilizumab. Drei Monate vor Auftreten der aktuellen Symptomatik war die Diagnose einer chronisch myelomonozytären Leukämie (CMML) gestellt worden. Die Hautbiopsie zeigte ein perivaskuläres Infiltrat aus mittelgroßen gering proliferierenden Zellen mit Positivität für CD123, CD303, TCL1 und CD4, sodass die Diagnose einer CMML-assoziierten Proliferation plasmazytoider dendritischer Zellen gestellt wurde. Die Differenzialdiagnose spezifischer kutaner Infiltrate bei der CMML wird diskutiert.

Abstract

A 72-year-old male patient presented with multiple erythematous plaques on the lower arms, lower legs and feet. The patient suffered from rheumatoid arthritis and accompanying interstitial granulomatous dermatitis under treatment with tocilizumab. Several months prior to presentation a chronic myelomonocytic leukemia (CMML) had been diagnosed. The skin biopsy showed a perivascular infiltration of medium-sized cells with positivity for CD123, CD303 and CD4 with a low proliferation activity so that a diagnosis of a CMML-associated proliferation of plasmacytoid dendritic cells was made. The differential diagnosis of specific cutaneous infiltrates in CMML is discussed.

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Authors and Affiliations

  1. Institut für Pathologie und Neuropathologie, Comprehensive Cancer Center und Universitätsklinikum Tübingen, Liebermeisterstraße 8, 72076, Tübingen, Deutschland

    B. Federmann, I. Bonzheim & F. Fend

  2. Universitäts-Hautklinik, Comprehensive Cancer Center und Universitätsklinikum Tübingen, Tübingen, Deutschland

    G. Metzler

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  1. B. Federmann
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  2. G. Metzler
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  3. I. Bonzheim
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  4. F. Fend
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Correspondence to B. Federmann.

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B. Federmann, G. Metzler, I. Bonzheim und F. Fend geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Federmann, B., Metzler, G., Bonzheim, I. et al. Differenzialdiagnose spezifischer Hautinfiltrate bei chronischer myelomonozytärer Leukämie. Pathologe 36, 494–497 (2015). https://doi.org/10.1007/s00292-015-0058-3

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  • DOI: https://doi.org/10.1007/s00292-015-0058-3

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