Subcutaneous panniculitis-like T-cell lymphoma misdiagnosed as lupus erythematosus panniculitis

Clin Rheumatol. 2007 Feb;26(2):244-6. doi: 10.1007/s10067-005-0125-x. Epub 2006 Jan 11.

Abstract

We report a case of subcutaneous panniculitis-like T-cell lymphoma (SPTCL), associated with macrophage activation syndrome, mimicking a lupus erythematosus panniculitis (LEP). A 29-year-old woman presented with high fever, general malaise, nausea, vomiting, and subcutaneous nodules and ulcerating lesions located on the lower extremities. The histopathology showed an infiltration of the panniculus, mostly involving fat, and periadnexial and perivascular structures consistent with lymphocytic lobular panniculitis (LLP). LLP is a shared feature of LEP and SPTCL. The immunophenotyping of the cell infiltrate was crucial for a correct diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Diagnosis, Differential
  • Doxorubicin / therapeutic use
  • Fatal Outcome
  • Female
  • Humans
  • Immunophenotyping
  • Lymphoma, T-Cell / complications
  • Lymphoma, T-Cell / drug therapy
  • Lymphoma, T-Cell / immunology
  • Lymphoma, T-Cell / pathology*
  • Macrophage Activation / immunology
  • Macrophages / immunology
  • Macrophages / pathology
  • Multiple Organ Failure
  • Panniculitis / drug therapy
  • Panniculitis / etiology
  • Panniculitis / immunology
  • Panniculitis / pathology*
  • Panniculitis, Lupus Erythematosus / diagnosis*
  • Subcutaneous Tissue / immunology
  • Subcutaneous Tissue / pathology*
  • Syndrome
  • Vincristine / therapeutic use

Substances

  • Vincristine
  • Doxorubicin
  • Cyclophosphamide