Cutaneous myelogenous leukaemia

Myelogenous leukaemias are a spectrum of diseases encompassing chronic myeloproliferative diseases, myelodysplastic disorders and acute myeloid leukaemias. Skin manifestations are more common in patients with acute myelogenous leukaemia of the French-American-British (FAB) classification subtypes M4 and M5 (acute myelomonocytic leukaemia, acute monoblastic leukaemia, acute monocytic leukaemia), but can be observed rarely in other subtypes of acute myeloid leukaemia, in a small percentage of patients with chronic myelogenous leukaemia and also in patients with myelodys-plastic syndromes [1-11].

Cases showing isolated extramedullary tumours with myeloid differentiation have been referred to as chloroma or granulocytic sarcoma in the past but are currently referred to as myeloid sarcomas [12-14]. Myeloid sarcoma may precede or be concomitant with myelogenous leukaemia.

There may be a relationship between myelogenous leukaemia and blastic NK-cell lymphomas (see Chapter 16).

Fig. 18.1 Cutaneous manifestations of myelogenous leukaemia. Large tumours on the chest in a 40-year-old patient without a leukaemic picture who developed overt leukaemia 2 months after the onset of skin lesions ('aleukaemic leukaemia cutis').

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