ABSTRACT
Epidermotropic metastases from internal malignancies are exceedingly rare. We report a striking example of epidermotropic metastatic carcinoma of the lower female genital tract to the skin of the abdomen and groin. Atypical cells were scattered throughout the epidermis, mimicking Bowen's disease. Focally, islands of atypical squamous cells were also found in the adjacent dermis. Histopathologically, the lesion resembled a primary invasive squamous cell carcinoma. However, the clinical history of a metastatic carcinoma of the genitalia and the clinical presentation with multiple lesions militated against a primary squamous cell carcinoma and favored interpretation of the lesions as epidermotropic metastases.
Subject(s)
Carcinoma, Squamous Cell/pathology , Skin Neoplasms/pathology , Vaginal Neoplasms/pathology , Bowen's Disease/pathology , Bowen's Disease/secondary , Carcinoma, Squamous Cell/secondary , Female , Humans , Middle Aged , Neoplasm Metastasis , Skin Neoplasms/secondary , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/surgery , Vaginal Neoplasms/secondarySubject(s)
Aneurysm/diagnostic imaging , Aneurysm/radiotherapy , Carotid Arteries , Edema , Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/radiotherapy , Angiography , Death, Sudden , Edema/etiology , Fatal Outcome , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , UltrasonographyABSTRACT
BACKGROUND: Specific cutaneous infiltrates in patients with leukemia generally carry a grim prognosis. However, non-neoplastic skin diseases may be associated with recruitment of normal and neoplastic leukocytes circulating in the peripheral blood. In those instances, neoplastic cells may be detected in skin lesions without an adverse effect on prognosis. METHODS: In a patient with B-cell chronic lymphocytic leukemia, a specific infiltrate developed at the site of a florid herpes simplex infection. Clinically, the lesion presented itself as an ulcerated tumor. RESULTS: Histopathologically, the lesion was characterized by a dense, diffuse infiltrate of small hyperchromatic lymphocytes throughout the entire dermis. Lymphocytes showed an aberrant CD20(+)/CD43(+)/CD5(+) phenotype of neoplastic B cells, and monoclonal rearrangement of immunoglobulin gamma genes could be demonstrated by polymerase chain reaction. Although criteria for leukemia cutis were fulfilled, the patient did well. CONCLUSIONS: The cutaneous infiltrate of neoplastic cells seemed to be part of a physiologic response to the antigenic stimulus, rather than indicating an exacerbation of leukemia. Ziemer M, Bornkessel A, Hahnfeld S, Weyers W. 'Specific' cutaneous infiltrate of B-cell chronic lymphocytic leukemia at the site of a florid herpes simplex infection.
