Subcutaneous Panniculitis-Like T-Cell Lymphoma With Hemophagocytic Lymphohistiocytosis

J Investig Med High Impact Case Rep. 2024 Jan-Dec:12:23247096241253337. doi: 10.1177/23247096241253337.

Abstract

Subcutaneous panniculitis-like T-cell lymphoma (SPTLP), a unique variant of primary cutaneous T-cell lymphomas, clinically mimics subcutaneous panniculitis. It is typified by the development of multiple plaques or subcutaneous erythematous nodules, predominantly on the extremities and trunk. Epidemiological findings reveal a greater incidence in females than males, affecting a wide demographic, including pediatric and adult cohorts, with a median onset age of around 30 years. Diagnosis of SPTLP is complex, hinging on skin biopsy analyses and the identification of T-cell lineage-specific immunohistochemical markers. Treatment modalities for SPTLP are varied; while corticosteroids may be beneficial initially for many patients, a substantial number require chemotherapy, especially in cases of poor response or relapse. Generally, SPTLP progresses slowly, yet approximately 20% of cases advance to hemophagocytic lymphohistiocytosis (HLH), often correlating with a negative prognosis. We report a case of a young male patient presenting with prolonged fever, multiple skin lesions accompanied by HLH, a poor clinical course, and eventual death, diagnosed postmortem with SPTLP. In addition, we also present a literature review of the current evidence of some updates related to SPTLP.

Keywords: hemophagocytic lymphohistiocyosis; subcutaneous panniculitis-like T-cell lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biopsy
  • Diagnosis, Differential
  • Fatal Outcome
  • Humans
  • Lymphohistiocytosis, Hemophagocytic* / complications
  • Lymphohistiocytosis, Hemophagocytic* / diagnosis
  • Lymphohistiocytosis, Hemophagocytic* / pathology
  • Lymphoma, T-Cell* / complications
  • Lymphoma, T-Cell* / diagnosis
  • Lymphoma, T-Cell* / pathology
  • Lymphoma, T-Cell, Cutaneous / complications
  • Lymphoma, T-Cell, Cutaneous / diagnosis
  • Lymphoma, T-Cell, Cutaneous / pathology
  • Male
  • Panniculitis* / diagnosis
  • Panniculitis* / pathology
  • Skin / pathology
  • Skin Neoplasms / complications
  • Skin Neoplasms / pathology
  • Young Adult