Unusual Presentation of Chronic Myelogenous Leukemia as Multiple Skin Chloromas Report of a Case with Clinical and Cytologic Correlation

Background Chronic myelogenous leukemia (CML) presenting as multiple skin chloromas is an extremely lore manifestation. Though often seen in acute myelogenous leukemia, to date there have been no reporter) cases of CML presenting its multiple skin chloromas in the chronic phase. Chloromas in blastic phase of CML at different body sites have been reported previously. Case A 53-year-old. African American male presented to his primary case provider with multiple skin nodules. A complete blood found showed a high white cell count, for which he was transferred to a University tertiary care center. Fine needle aspiration (FNA) of the skin lesion revealed cellular smears consisting of immature myeloid cells of CML. Based on those findings, read;rich clinical correlation, a preliminary diagnosis of chloroma wars made and confirmed by ancillary studies. Conclusion This rare manifestation should alert a clinician to include, CML is chronic phase in the differential diagnosis of patients presenting with multiple nonpigmented, nonpruritic skin nodules. FNA with ancillary, studies can provide a rapid diagnosis. (Acta Cytol 2009;53:235-238)