Abstract:
Acute lymphoblastic leukemia/lymphoma is a highly aggressive neoplasm
of precursor lymphoid (blast) cells. There are 2 main subtypes based on lymphoid lineage; B lymphoblastic leukemia/lymphoma (B-ALL/LBL) and T lymphoblastic leukemia/lymphoma (T-ALL/LBL). B-ALL/LBL commonly presents
with fever, fatigue, bone or joint pain, bleeding or anorexia (signs of bone
marrow infiltration), lymphadenopathy, hepatosplenomegaly, involvement of
skin, soft tissue and testes, with a predilection for the central nervous system.
Immature cell markers, such as CD34 and TdT, can help to differentiate lymphoblasts from Burkitt lymphoma which, is considered a mature high-grade B
cell lymphoma that mimics lymphoblastic lymphoma/leukemia. Unfavorable
prognostic factors include: infancy and adult age of diagnosis, high white
blood cell count, slow response to initial therapy, central nervous system involvement at the time of diagnosis and Minimal residual disease after therapy.
We present a case report of a 4 months old infant seen at a Tertiary Hospital
with a rare presentation of CD34 Negative B-lymphoblastic leukemia/lymphoma
presenting as cutaneous lesions in infancy.
