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Blastic plasmacytoid dendritic cell neoplasm

Blastic plasmacytoid dendritic cell neoplasm
#00014085
Author: Fanny Angelot-Delettre and Francine Garnache-Ottou
Category: Macrophage/Histiocytic and dendritic cell Neoplasms and disorders (2015) > Other reactive and neoplastic Macrophage/dendritic lesions > Interdigitating dendritic cell sarcoma
Published Date: 12/09/2012

An 81-year-old man had multiple skin lesions (brown-red plaques on the face, abdomen, and back) and asthenia. There was no hepatosplenomegaly . Despite normal blood count values, the peripheral smear contained blasts (7%). Bone marrow examination showed 50% of blasts and mild erythroid dysplasia. The abnormal cells were medium-sized with blastic round (panels A-B) or convoluted (panels C-D,H) nuclei, fine to slightly condensed chromatin, and variable nucleoli. Some blasts had a pseudolymphoid appearance (panel B). The cytoplasm had faint heterogeneous basophilia, no granulation, and peripherally located vacuoles (panels A-F). Occasional cells with pseudopodia were present (panels F-H). Myeloperoxidase and butyrate esterase was negative. Flow cytometry showed a CD45low population expressing CD4, CD56, CD303, CD304, and high levels of CD123 and TCL1. There was no T-cell, B-cell or myeloid expression except for CD33 and CD2, and no expression of CD34 or Tdt.