Differentiation syndrome during ivosidenib treatment with immunohistochemistry showing isocitrate dehydrogenase R132H mutation
| العنوان: | Differentiation syndrome during ivosidenib treatment with immunohistochemistry showing isocitrate dehydrogenase |
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| المؤلفون: | Melissa Chase, Sebastian Fernandez-Pol, Mika M. Tabata, Roberto A. Novoa, Bernice Y. Kwong |
| المصدر: | Journal of Cutaneous Pathology. 47:1042-1045 |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Pathology, medicine.medical_specialty, Histology, Dermatology, Pathology and Forensic Medicine, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Immunophenotyping, hemic and lymphatic diseases, Medicine, medicine.diagnostic_test, biology, business.industry, CD117, Sweet Syndrome, Karyorrhexis, Myeloid leukemia, Leukemia cutis, medicine.disease, Leukemia, 030220 oncology & carcinogenesis, Skin biopsy, biology.protein, medicine.symptom, business |
| الوصف: | We report a case of differentiation syndrome in a patient receiving the IDH1 inhibitor ivosidenib, with skin biopsy showing isocitrate dehydrogenase (IDH) R132H-mutated leukemia cutis. A 72-year-old man with IDH1-mutated acute myeloid leukemia (AML), status-post allogeneic cell transplantation, on ivosidenib for six months, was admitted for culture-negative neutropenic fever, pink and purpuric plaques and patches on the legs, abdomen and back, edema, hypotension, and shortness of breath. Skin biopsy revealed an infiltrate of atypical, immature, myeloperoxidase-positive mononuclear cells compatible with leukemia cutis or Sweet syndrome. Although dermal edema and interstitial neutrophilic infiltrate with karyorrhexis characteristic of Sweet syndrome were not seen, the atypical cells lacked expression of CD117 and CD34, which were expressed in the original leukemia. Additional immunohistochemical staining of suspected blasts was strongly positive for IDH1 R132H, suggesting a diagnosis of leukemia cutis. As the immunophenotype of blasts in skin infiltrates can significantly differ from the immunophenotype seen in blood and bone marrow, this case demonstrates that mutation-specific antibodies such as anti-IDH1 R132H may be useful to help distinguish malignant from non-malignant infiltrates in the skin. Furthermore, differentiation syndrome may demonstrate histologic features of leukemia cutis on skin biopsy. This article is protected by copyright. All rights reserved. |
| تدمد: | 1600-0560 0303-6987 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::523b96e137251a24dfd1578e44c730a6Test https://doi.org/10.1111/cup.13780Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi...........523b96e137251a24dfd1578e44c730a6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16000560 03036987 |
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