{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:06:22Z","timestamp":1792033582557,"version":"4.4.0"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T00:00:00Z","timestamp":1506470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>\n<jats:styled-content>Chronic myelomonocytic leukemia (CMML) is a hematopoietic stem cell neoplasm exhibiting both myelodysplastic and myeloproliferative features. Cutaneous involvement by CMML is critical to recognize as it typically is a harbinger of disease progression and an increased incidence of transformation to acute myeloid leukemia. Cutaneous lesions of CMML exhibit heterogeneous histopathologic features that can be challenging to recognize as CMML. We describe a 67\u2010year\u2010old man with a 3\u2010year history of CMML who had been managed on single\u2010agent azacitidine with stable disease before developing splenomegaly and acute onset skin lesions. Examination of these skin lesions revealed a dense infiltrate of histiocytic cells morphologically resembling Langerhans type cells (lacking frank histopathologic atypia), and with the immunophenotype of an indeterminate cell histiocytosis (S100+ CD1a+ and langerin\u2212). Given the history of CMML, next\u2010generation sequencing studies were performed on the skin biopsy. These revealed a KRAS (p.G12R) mutation identical to that seen in the CMML 3\u2009years prior, establishing a clonal relationship between the 2 processes. This case expands the spectrum for and underscores the protean nature of cutaneous involvement by CMML and underscores the importance of heightened vigilance when evaluating skin lesions of CMML patients.<\/jats:styled-content><\/jats:p>","DOI":"10.1111\/cup.13039","type":"journal-article","created":{"date-parts":[[2017,9,8]],"date-time":"2017-09-08T12:32:44Z","timestamp":1504873964000},"page":"1075-1079","source":"Crossref","is-referenced-by-count":35,"title":["Chronic myelomonocytic leukemia masquerading as cutaneous indeterminate dendritic cell tumor: Expanding the spectrum of skin lesions in chronic myelomonocytic leukemia"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8980-3202","authenticated-orcid":false,"given":"Sanam","family":"Loghavi","sequence":"first","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0630-6222","authenticated-orcid":false,"given":"Jonathan L.","family":"Curry","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center  Houston Texas"},{"name":"Department of Dermatology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Garcia\u2010Manero","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyur P.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"Khoury","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Torres\u2010Cabala","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center  Houston Texas"},{"name":"Department of Dermatology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyadharsini","family":"Nagarajan","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyu P.","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard R.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Dermatology The University of Texas Medical Branch  Galveston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon P.","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Department of Dermatology The University of Texas Medical Branch  Galveston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent C.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Dermatology The University of Texas Medical Branch  Galveston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brinda R.","family":"Korivi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Jeffrey","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor G.","family":"Prieto","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center  Houston Texas"},{"name":"Department of Dermatology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagop M.","family":"Kantarjian","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos E.","family":"Bueso\u2010Ramos","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Tetzlaff","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center  Houston Texas"},{"name":"Department of Translational and Molecular Pathology The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,27]]},"reference":[{"key":"e_1_2_4_2_1","first-page":"76","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Orazi A","year":"2008"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2011.05.003"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31825dd4de"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2013.122"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqv023"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318283099f"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2009.021212"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000000775"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.12417"},{"issue":"5","key":"e_1_2_4_11_1","first-page":"409","article-title":"Langerhans cell histiocytosis and myelomonocytic leukemia: a non\u2010fortuitous association","volume":"126","author":"Baikian B","year":"1999","journal-title":"Ann Dermatol Venereol"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-11-749374"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-011-0787-x"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(79)90317-9"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12598"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcup.13039","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.13039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T13:21:29Z","timestamp":1695561689000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.13039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,27]]},"references-count":14,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/cup.13039"],"URL":"https:\/\/doi.org\/10.1111\/cup.13039","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,27]]}}}