Unusual cutaneous manifestations of chronic lymphocytic leukaemia with increased prolymphocytes

Chronic lymphocytic leukaemia with increased prolymphocytes (CLL/PL) is an aggressive form of atypical chronic lymphocytic leukaemia (CLL). Skin lesions associated with B-cell non-Hodgkin lymphomas are rare manifestations compared to T-cell non-Hodgkin lymphomas. Cutaneous presentations are divided into specific and non-specific changes. Specific skin involvement in B-cell non-Hodgkin lymphoma represents secondary cutaneous manifestations of systemic B-cell lymphoma, primary cutaneous B-cell lymphoma (PCBCL), or any other cancer. However, the most frequently observed eruptions are the non-specific skin lesions. They can be either haemorrhagic, of infectious aetiology, or a drug-induced reaction after chemotherapy. We present a case of a 61-year-old Caucasian man who was admitted to the Department of Haematology at University Hospital in Bialystok due to an abnormal complete blood count (WBC 54 G/l, HgB 13.6 g/dl, PLT 334 000/ml, 25% of prolymphocytes in smear) and the presence of numerous tumours with a diameter of 6 cm to 35 cm, some being within the area of the skin and some within the subcutaneous tissue. This patient’s case is very interesting because of the rarity of this disease as well as the presence of unusual specific skin lesions. B-cell lymphomas are a heterogeneous group of clonal lymphoproliferative disorders, and they have a wide range of skin manifestations. For this reason a comprehensive diagnostic profile is crucial as it is the key to proper diagnosis and allows for the application of an appropriate treatment.