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March 2009

Multiple Violaceous Nodules in a Neonate—Diagnosis

Author Affiliations
 

MICHAEL E.MINGMD, MSCE

 

CARRIE ANN R.CUSACKMDSENAIT W.DYSONMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMDKARLA S.ROSENMANMD

Arch Dermatol. 2009;145(3):321-326. doi:10.1001/archdermatol.2008.626-b

Histopathologic examination revealed diffuse dermal and subcutaneous infiltration by monomorphic cells with a thin rim of eosinophilic cytoplasm, large hyperchromatic nuclei, and high mitotic activity. Histopathologic staining was positive for leukocyte common antigen in these cells. The peripheral blood smear showed that 34% of the myeloid series of cells were monoblasts, bone marrow aspirate results showed 71% blast cells, and a biopsy specimen confirmed the diagnosis of congenital acute myeloid leukemia, with flow cytometry findings positive for M4 and M5 phenotype. Cytogenetic analysis of peripheral blood by G-banding revealed a normal karyotype. Complete remission was attained with multidrug chemotherapy, with no recurrence at the 1-year follow-up examination.

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