Secondary cutaneous infiltration in B cell chronic lymphocytic leukemia

We describe a patient presenting with B cell chronic lymphocytic leukemia ( B-CLL) who subsequently developed cutaneous infiltrates. Specimens of the b lood, bone marrow and cutaneous infiltrations all showed the same heavy-cha in gene rearrangement. Following failure of conventional chemotherapy, and in view of the similarity of the disease to cutaneous T cell lymphoma, inte rferon-cr therapy was employed with satisfactory results. Introduction of t h is cytokine to the therapeutic modalities for secondary cutaneous B-CLL w ould hopefully change the poor outcome of this entity, or at least could pr oduce a better quality of life. Loss of histidine decarboxylase activity in the infiltrating cells - in contrast to circulating lymphocytes - may be a ssociated with the transformation of B-CLL to a more aggressive infiltrativ e form, offering a possible explanation for tissue invasiveness. The changi ng character of the disease raises the possibility of a second mutational e vent in the course of B-CLL. Copyright (C) 2000 S. Karger AG. Basel.