Acute monocytic leukemia presenting as generalized lymphadenopathy and skin rash in a toddler: highlighting the clinicopathologic mimics. Issue 4 (23rd October 2020)

• Record Type: Journal Article
• Authors: Jain, Aleena; Gupta, Parikshaa; Gupta, Nalini; Senguttuvan, Gnanamani; Kapadia, Alpeshkumar Bipinbhai; Thirunavukkarasu, Balamurugan; Nada, Ritambhra; Varma, Neelam
• Is Part Of: Diagnostic cytopathology. Volume 49:Issue 4(2021)
• Page Start: E156
• Page End: E163
• Publication Date: 2020-10-23
• Subjects: acute monocytic leukemia -- acute myeloid leukemia -- chloroma -- CNS involvement -- cytology -- fine‐needle aspiration cytology -- generalized lymphadenopathy; Cytodiagnosis -- Periodicals; Pathology, Cellular -- Periodicals; Cytology -- Periodicals; 616.07582
• DOI: 10.1002/dc.24649
• Languages: English
• ISSNs: 8755-1039

Abstract

Abstract: Acute myeloid leukemia (AML) is the fifth most common malignancy in children. Extramedullary involvement in acute myeloid leukemia is rare and can be seen in soft tissues, central nervous system, skin and lymphoreticular organs. The clinical presentations can often be non‐specific and hence, the diagnosis can be very challenging, especially in cases without a prior hematologic diagnosis. We report a case of pediatric acute monocytic leukemia presenting with generalized lymphadenopathy and cutaneous rash. Fine‐needle aspiration was performed from the lymph nodes and a cytologic diagnosis of infiltration by a lymphoreticular malignancy was suggested. Peripheral blood, bone marrow and cerebrospinal fluid involvement were noted subsequently. Flow cytometry on the bone marrow aspirate confirmed a diagnosis of acute monocytic leukemia. The index case besides highlighting an uncommon presentation of acute monocytic leukemia in a toddler, also emphasizes the need to consider acute monocytic leukemia as a cytomorphologic differential in such presentations.