ArticleCase reports in hematology2025
Subcutaneous Leukemia Cutis as the Initial Manifestation of CD23 Negative CLL/SLL in a Patient With Rheumatoid Arthritis on Chronic TNF-Alpha Inhibition.
Article in Case reports in hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Leukemic penile ulcer as the presenting symptom of chronic lymphatic leukemia.Journal of surgical case reports · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Rheumatoid arthritis (RA) is a chronic, systemic, and autoimmune disease characterized by inflammation and pain in the joints. While RA and TNF-alpha inhibitors have historically been associated with an increased risk of lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is infrequently seen. CD23 negative CLL is rare. Extranodal manifestations of CLL/SLL are uncommon. While cutaneous involvement is among the more common extranodal manifestations, leukemia cutis is rare. Furthermore, subcutaneous leukemia cutis as the initial manifestation CLL/SLL is exceedingly uncommon. We describe a patient with longstanding RA on chronic TNF-alpha inhibition who presented with an isolated subcutaneous mass. Excisional biopsy demonstrated sheets of small, uniform, and mature lymphocytes with flow cytometric analysis noting a monoclonal B-cell population negative for CD23 expression but positive for CD5, CD19, CD20, CD38, kappa light chain, and CD200 expression. Further immunostaining was negative for cyclin-D1 and SOX11 and positive for CD43 and LEF1, overall consistent with CLL/SLL-induced subcutaneous leukemia cutis. While treatments for CLL/SLL-induced leukemia cutis vary, in this case, consolidative local radiation led to resolution of the remaining cutaneous lesion. Caution is advised when considering the use of TNF-alpha inhibitors in patients with a history of lymphoma.
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Registered trials
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