Sclerosing Extramedullary Haematopoietic Tumour Presenting as Bilateral Gluteal Abscess in a Patient with Chronic Myelogenous Leukaemia ED16-ED18
KS Sunil Kumar,
Consultant, Department of Histopathology, Apollo Hospitals, Greams Road, Chennai-600006, Tamil Nadu, India.
Sclerosing Extramedullary Haematopoietic Tumours (SEMHT) are found to be associated with Chronic Myeloproliferative Neoplasms most commonly reported in the skin, lacrimal system, orbit, omentum and liver. A 26-year-old male with a known history of Chronic Myelogenous Leukaemia (CML) sought medical attention for non-healing ulcerated lesions on both gluteal regions. Histopathological examination revealed patchy skin ulceration with dermal abscess formation, dense-periadnexal and perivascular extramedullary haematopoietic elements comprising of erythroid progenitors, granulocytes with all stages of maturation and atypical megakaryocytes extending into subcutaneous fat. Immunohistochemistry confirmed the lineage of erythroid progenitors by Glycophorin, granulocyte lineage by Myeloperoxidase and megakaryocytes by CD61 staining. CD34, CD30 and CD15 immunoreactivity were negative. Keeping this differential diagnosis in mind is essential while reporting a sclerotic lesion with extramedullary haematopoietic elements in a clinical setting of Chronic Myeloproliferative Neoplasms to prevent inaccurate diagnosis and unnecessary surgeries.