Subcutaneous Sweet syndrome with nuclear segmentation anomalies: a diagnostic marker of myelodysplasia

摘要

A 43-year-old male patient presented with a medical history of myelodysplastic syndrome (MDS), refractory cytopenia with multilineage dysplasia. The patient reported a io-day history of an erythematous, tender plaques on the dorsum of his foot (Fig. ia). The lesions appeared with recurrence of malaise and fever.Pancytopenia with hyposegmented neutrophils with bilobed nuclei (pseudo Pelger-Huet anomaly) was observed in his peripheral blood smear. The biopsy results showed an inflammatory cell infiltrate composed of predominant neutrophils limited to the subcutaneous tissue without extending into the dermis or epidermis (Fig. ib). At higher magnification, pseudo Pelger-Huet anomaly was observed (Fig. ic). A few medium-sized mononuclear cells stained strongly positive for myeloperoxidase (Fig. id). His intermittent fever and skin lesions slowly improved without special treatment.