SKIN INFILTRATION IN ACUTE PROMYELOCYTIC LEUKEMIA

Acute promyelocytic leukemia (APL) is a type of acute leukemia showing unique clinical. morphological and cytogenetic features, A skin infil tration by APL cells is an extremely rare occasion, but there have bee n several case reports of leukemia cutis in APL, in which all-trans re tinoic acid (ATRA) may have induced the skin infiltration. However, no immunohistochemical analyses of the APL cells in the skin have been d one to date, A 30-year-old woman with APL developed multiple reddish p urple nodules on the extremities in her second complete remission. His tological findings revealed a dense infiltration of medium to large at ypical cells, which were positive for myeloperoxidase, throughout the dermis, Despite the conventional chemotherapy and ATRA therapy she die d iom disseminated intravascular coagulation during her third relapse. Leukemic cells in the peripheral blood before the treatment with ATRA revealed -/CD13++/CD14-/CD19-/CD20-/CD33++/CD38++/CD41-/Ia, but they expressed -/CD13++/CD14-/CD19-/CD20-/CD33++/CD38++/CD41+/Ia+ after the treatment. suggest that the alternation of the surface molecules on t he tumor cells is closely associated with the skin infiltration of APL cells.