Outcome and clinico-phenotypical features of acute Lymphoblastic leukemia/lymphoma with cutaneous involvement: a multicentric case-series

Figure 2. Various clinical aspects of skin involvement in ALL/LBL. A. Multiple head nodules/tumors in a child with T-LBL. B. Unique nodule/tumor on the arm in an adult patient with B-LBL. C. Multiple ulcerative lesions on the back of the leg in an adult patient with T-LBL. Abbreviations : LBL, lymphoblastic lymphoma Figure 3. Histological and immunohistochemical aspects of ALL/LBL. A. Skin biopsy of a T-LBL with a tumoral infiltrate involving the full height of the sample (Low magnification, H&E staining in FFPE sample). B. The infiltrate spares the epidermis (Medium magnification, H&E staining in FFPE sample). C. The infiltrate is composed of medium to large size cells with minimal cytoplasm, fine dusty chromatin, absent to inconspicuous nucleoli and irregular nuclear contour (High magnification, H&E staining in FFPE sample). D. Diffuse nuclear positive Ki67 immunostaining with high intensity in a T-LBL (Low magnification). E. Diffuse nuclear positive TdT immunostaining with medium intensity in a T-LBL (Low magnification). Abbreviations : LBL, lymphoblastic lymphoma; H&E, hematoxylin & eosin; FFPE, formalin-fixed paraffin-embbeded; TdT, terminal deoxynucleotidyl transferase. Table 2: Comparison of cutaneous immunohistochemical expression with bone marrow flow cytometric phenotype. Bold and underlined: antigens with discordant expression by leukemic cells in skin versus bone marrow NA: not available Table 3: Molecular features of the cohort