Blastic plasmacytoid dendritic cell neoplasm: a diagnosis not to be missed, about three case reports

Abstract

Introduction : Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a proliferation of plasmacytoid cell precursors. It is a rare and difficult-to-diagnose hematological malignancy with a poor outcome.

Case presentation: We report three cases of BPDCN diagnosed in patients of different nationalities (Tunisian, Algerian and Libyan) and varying ages (eight, 65 and 74 years old). Cutaneous involvement was present in all three cases. Cytology was inconclusive in the first case, in favor of acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) in the second and third case respectively. The diagnosis was retained by flow cytometry, highlighting the Cluster of Differentiation (CD) 4 + CD56 + phenotype of the blast population.

Conclusion: These observations illustrate diagnosis challenges, the importance of biological/clinical confrontation in order not to misdiagnose this entity. Flow
cytometry is an essential diagnostic tool.