Insektenstichähnliche Hautveränderungen als Initialmanifestation maligner hämatologischer Erkrankungen

Zusammenfassung

Ein 80-jähriger Patient entwickelte am frontalen Kapillitium einen livid-rötlichen Knoten, der wegen des Verdachts eines Zeckenlymphozytoms erfolglos mit Tetrazyklinen behandelt wurde. Eine Biopsie des Knotens ließ ein myeloisches Infiltrat vermuten und führte in Verbindung mit der Knochenmarkhistologie und -zytologie zunächst zur Diagnose einer chronisch-myelomonozytären Leukämie (CMMoL). Im weiteren Verlauf entwickelte der Patient jedoch das Bild einer akuten Leukose mit über 90 % Blasten im peripheren Blut und Knochenmark. Die zytochemische und immunphänotypische Diagnostik ergab den Befund einer prä-T-ALL (akute lymphatische Leukämie).

Insect-Bite Like Reactions as Initial Manifestation of Malignant Hematological Diseases: Case Report and Literature Review

An 80-year old patient presented with a livid-red frontal nodule that was treated unsuccessfully with tetracyclines under the diagnosis of a borrelia lymphocytoma. Initially, histopathology of the nodule revealed a myeloic infiltration and, based on bone marrow smears and biopsy, a chronic-myelomonocytic leukemia (CMMoL) was diagnosed. In the course of the disease the patient developed an acute leukosis with more than 90 % blasts in the peripheral blood and bone marrow. Cytochemical and immunophenotypical diagnosis showed a pre-T-ALL (acute lymphoblastic leukemia with T-cell-phenotype).

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