To the Editor.—
Acute myelofibrosis1,2 is a rare clinicopathologic entity characterized by acute onset; rapidly progressive clinical course; nonspecific symptoms such as weight loss, anorexia, fatigue, and weakness; absence of organomegaly; pancytopenia; circulating blast cells; and mild abnormalities in red blood cell morphology. The bone marrow aspirates are usually "dry" and bone marrow biopsy specimens show an increased cellularity, reticulin fibrosis, proliferation of blast cells, and atypical megakaryocytes. This rare entity was initially considered an acute variant of chronic myelofibrosis.2 Cutaneous extramedullary hematopoiesis has been rarely described in patients with chronic myelofibrosis3,4; however, it has not been previously reported in association with acute myelofibrosis. We report a case of cutaneous extramedullary hematopoiesis in a patient with acute myelofibrosis.
Report of a Case.—
A 48-year-old woman was admitted to our hospital because of fever and malaise. She was well until one month earlier, when she noted anorexia. Twelve