Bone marrow coexistence of chronic lymphocytic leukemia and Langerhans cell sarcoma

Left Forearm Langerhans Cell Sarcoma Demonstrated by 18F-FDG PET/CT

ABSTRACT

Langerhans cell sarcoma is a rare neoplastic proliferation of Langerhans cells with a poor prognosis. We report FDG PET/CT findings of Langerhans cell sarcoma in the left forearm of a 77-year-old woman who presented with progressive enlargement of the left forearm mass for over 2 months. 18F-FDG PET/CT demonstrated a high FDG uptake by the mass along with several FDG-avid enlarged lymph nodes in the left arm and axilla. Pathology examination of the biopsied specimen from the left forearm mass led to a diagnosis of Langerhans cell sarcoma.

Chronic lymphocytic leukemia/small lymphocytic lymphoma complicated with skin Langerhans cell sarcoma: A case report

BACKGROUND

Langerhans cell sarcoma (LCS) is a rare malignancy with poor prognosis. LCS and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) can occur in the same diseased tissues, such as lymph nodes or skin.

CASE SUMMARY

A 48-year-old female Han Chinese patient was admitted for generalized lymph node enlargement for 6 years and abdominal distension for 1 wk. She was diagnosed with small B-cell lymphoma (stage IV)/CLL (Benet stage B) and received chemotherapy. She started oral ibrutinib in February 2019. She was hospitalized on June 11, 2019, and a 1.5 cm × 1.5 cm dark-red nodule with ulceration scalp lesion was found. Biopsy revealed LCS but without CLL/SLL. She was diagnosed with CLL/SLL (Binet stage C, Rai stage IV) accompanied by secondary histiocytic sarcomas and skin LCS and received cyclophosphamide, doxorubicin, vincristine, dexamethasone, and etoposide but developed severe cytopenia. She ultimately refused treatments and discharged spontaneously. She died on September 12, 2019. The literature review showed that in patients with CLL/SLL, skin lesions of LCS are accompanied by CLL/SLL. This patient was different from the previously reported cases of skin LCS in patients with CLL/SLL.

CONCLUSION

In this patient, the skin lesion of LCS showed no concomitant CLL/SLL.