Blastic Plasmacytoid Dendritic Cell Neoplasm: Updates in Diagnostic and Molecular Pathology

Surg Pathol Clin. 2026 Mar;19(1):131-144. doi: 10.1016/j.path.2025.08.008. Epub 2025 Nov 25.

Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive form of acute leukemia. BPDCN has a strong predilection for the skin and poses diagnostic challenges with clinical and histologic features that overlap with other conditions. BPDCN shows recurrent myeloid-associated mutations, complex chromosomal aberrancies, and copy-number changes with chromosomal losses involving tumor suppressors and cell cycle regulators. In patients with cutaneous BPDCN, the bone marrow frequently harbors mutationally related myeloid clones/neoplasms; BPDCN transforms from underlying premalignant hematopoietic clones with acquisition of additional progression events, and often occurs in association with ultraviolet damage in sun-exposed sites.

Keywords: BPDCN; Genetic updates; Immunohistochemistry; Mutational patterns; Plasmacytoid dendritic cells; pDC neoplasm.

Publication types

  • Review

MeSH terms

  • Blastic Plasmacytoid Dendritic Cell Neoplasm
  • Dendritic Cells* / pathology
  • Diagnosis, Differential
  • Hematologic Neoplasms* / diagnosis
  • Hematologic Neoplasms* / genetics
  • Hematologic Neoplasms* / pathology
  • Humans
  • Mutation
  • Pathology, Molecular
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / genetics
  • Skin Neoplasms* / pathology