An 88-year-old Japanese man visited our clinic complaining of itching on his upper back, which had persisted for 6 months. A physical examination revealed two erythematous tumors located on his upper back (sizes : 65×28 mm and 28×22 mm) and another in the right retroaxillar region (size : 22×18 mm). Blood tests detected a slightly elevated soluble interleukin 2 receptor level (788 U/mL). A biopsy examination demonstrated markedly dense infiltrates of lymphoid cells in the dermis and subcutis without lymphoid follicles. These cells were mainly small, but were mixed with medium-sized to large cells. Immunohistochemically, most of the small cells exhibited similar levels of positive staining for cluster of differentiation (CD) 3 and CD20, whereas the medium-sized and large cells tested positive for CD20 and partially positive for CD30. We diagnosed the patient with cutaneous pseudolymphoma. An intralesional injection of triamcinolone acetonide, once a month, was effective, and the tumors disappeared. No relapse has been detected for 1.5 years. Careful long-term follow-up is necessary because malignant lymphoma can occasionally occur in such cases.[Skin Cancer (Japan) 2018 ; 33 : 148-153]

An 80-year-old Japanese woman presented with a 1-month history of violaceous, hemorrhagic nodules, and purpura on her right leg. We first diagnosed her with Stewart-Treves syndrome by angiosarcoma based on her medical history of surgery and irradiation for cervical cancer and chronic bilateral lymphedema of the legs. Histopathological examination demonstrated diffuse epithelioid proliferation of atypical tumor cells, some of which contained intracytoplasmic vacuoles and red blood cells. The tumor cells were diffusely immunoreactive for D2-40 and tested negative for other stains. After the diagnosis of epithelioid angiosarcoma, we administered irradiation and chemotherapy containing paclitaxel ; however, she died because of hemorrhagic pneumothorax by lung metastases of epithelioid angiosarcoma. Epithelioid angiosarcomas are rare variants of angiosarcoma that mainly originate in soft tissues. Our case demonstrated unusual pathological characteristics of epithelioid angiosarcoma. Variant types of angiosarcoma and other undifferentiated sarcomas should be included among the differential diagnoses of tumors in Stewart-Treves syndrome.[Skin Cancer (Japan) 2018 ; 33 : 154-157]

Leukemia cutis is an extramedullary infiltration of granulocytic precursor cells in the skin. It usually presents as various types of eruption in the course of acute myelogenous leukemia ; skin lesions rarely develop in hematologic remission of acute myelogenous leukemia. In such cases, aleukemic leukemia cutis can be a preceding sign of systemic leukemia or the first sign of hematologic relapse of leukemia. We report an unusual case of leukemia cutis that developed in a patient with hematological remission of acute myelogenous leukemia. It is noteworthy to know that leukemia cutis could develop even if a patient is in the aleukemic state following remission.[Skin Cancer (Japan) 2018 ; 33 : 158－162]