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Minimally differentiated acute myeloid leukaemia revealed by specific cutaneous lesions

Summary Minimally differentiated acute myeloid leukaemia (AML‐MO) is a poorly differentiated type of acute myeloid leukaemia. Its myeloid differentiation can only be demonstrated by the immunohistochemical or ultrastructural finding of cytoplasmic myeloperoxidase in bone marrow blasts and/or by the immunohistochemical expression of at least one lineage‐specific myeloid antigen, with no reactivity for lymphoid antigens. We describe a man with a cutaneous nodular eruption that represented the first clinical manifestation of AML‐MO. Histological examination showed extensive proliferation of blasts with scant basophilie cytoplasm. Immunohistochemically, these expressed neither myeloid nor lymphoid‐specific antigens, whereas they were focally positive for CD45. The diagnosis of AML‐MO was confirmed by immunophenotypic analysis of a bone marrow smear. A complete remission was achieved following parenteral steroid therapy. The disease relapsed some months later, and the patient died within a few weeks.