Chronic lymphocytic leukemia/small lymphocytic lymphoma complicated with skin Langerhans cell sarcoma: A case report

Figure 1 Morphology and skin biopsy of the scalp lesion. The patient was admitted for the fourth time and was diagnosed as chronic lymphocytic leukemia/small lymphocytic lymphoma complicated with skin Langerhans cell sarcoma). A: Lesion on the left side of the head, looking like a hanging bag, with a soft texture, a slightly hard base, and ulceration and blood scabs at the tip; B: Skin tissue local ulcer formation (hematoxylin and eosin [HE], × 10); C: Ulcer showed mixed cell proliferation, vascular proliferation (HE, × 20); D: Some cells were enlarged, with a rich cytoplasm, light staining, mononuclear, binuclear, multinucleated, or lobulated nucleus; phagocytosis of lymphocytes could be seen in some cytoplasm. In the background, there were more scattered lymphocytes, neutrophils, and local interstitial mucoid degeneration pustular folliculitis (HE, × 100); E: Some cells were enlarged, with a rich cytoplasm, light staining, mononuclear, binuclear, multinucleated, or lobulated nucleus; phagocytosis of lymphocytes could be seen in some cytoplasm. In the background, there were more scattered lymphocytes, neutrophils, and local interstitial mucoid degeneration pustular folliculitis (HE, × 200).

Figure 2 Immunohistochemical results. A: Positive immunostaining of cells for CD207/Langerin (magnification × 200); B: Positive immunostaining of cells for CD1a (magnification × 400); C: Positive immunostaining of cells for CD68 (magnification × 400); D: Positive immunostaining of cells for S100 protein (magnification × 200); E: A high proliferation index (Ki67 immunostaining > 80%, magnification × 400); F: Negative Epstein-Barr encoding region mRNA by in situ hybridization.