A case of sarcoid reactions precedingacute myeloid leukemia

A 49-year-old man visited our hospital with high fever (up to 39°C), tender erythematous nodules, and bilateral infiltration of cutaneous scars on the patellae. Histopathological examination revealed that both the eruptions had noncaseating epithelioid granulomas with foreign bodies in the middle. Angiotensin-converting enzyme (ACE) and serum calcium levels were normal. Successful regression was achieved using oral steroids, but the patient had to be admitted to the hospital because of febrile neutropenia. Bone-marrow biopsy confirmed the diagnosis of acute myeloid leukemia (AML) and sarcoid reaction precedingAML. The patient had been previously diagnosed with thrombocytopenia, which indicated the possibility of progression to AML from myelodysplastic syndrome (MDS). The patient was treated with chemotherapy, and no recurrence of eruptions was noted. We reviewed cases of sarcoidosis or sarcoid reaction precedingAML in the literature. To date, only 2 cases of sarcoid reaction precedingAML have been reported.