title: Acute undifferentiated leukemia (stem cell acute leukemia) showing differentiation to Langerhans cell-like cells in lymph nodes.
abstract: A 75-year-old woman was referred to our hospital with suspected leukemia. Complete blood count demonstrated WBC 3,810/µl with 26% blasts, Hb of 11.7 g/dl and Plt of 18.0×104/µl. Bone marrow aspiration revealed blasts (86.3%) with expressions of CD34, CD7, TdT, CD33, and CD117. MPO was negative. Chromosomal analysis of the bone marrow showed isolated trisomy 10 in all leukemic cells (20/20). Swelling of superficial lymph nodes was also observed. Cervical lymph node biopsy revealed leukemic blasts which had the same phenotype as those in the bone marrow except that proliferation of Langerhans cell-like cells (LCs) was observed in the paracortex. LCs had pale cytoplasm and grooved nuclei, and were positive for both CD1a and S100 protein. Trisomy 10 was detected in both the leukemic blasts and the LCs by fluorescence in situ hybridization. This rare case strongly suggests leukemic cells to differentiate into LCs.
authors.affiliation: Department of Pathology, Tottori Prefectural Central Hospital.
authors.forename: Takanori
authors.initials: T
authors.lastname: Fukuta
authors.forename: Shu
authors.initials: S
authors.lastname: Nakamoto
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tokuyasu
authors.forename: Junko
authors.initials: J
authors.lastname: Maruyama
authors.forename: Hiromi
authors.initials: H
authors.lastname: Omura
authors.forename: Norihiko
authors.initials: N
authors.lastname: Hino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwamoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Murakami
mesh_terms: D000208:Acute Disease; D000368:Aged; D001853:Bone Marrow / Q000473:pathology; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology*; D007938:Leukemia / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D013234:Stem Cells / Q000473:pathology*