Subcutaneous panniculitis-like T-cell lymphoma: Clinical features, therapeutic approach, and outcome in a case series of 16 patients

J Am Acad Dermatol. 2018 Nov;79(5):892-898. doi: 10.1016/j.jaad.2018.05.1243. Epub 2018 Aug 17.

Abstract

Background: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare primary cutaneous lymphoma of mature cytotoxic T cells. Initially, patients with SPTCL were treated with doxorubicin-based polychemotherapy.

Objective: To analyze clinical, biologic, immunophenotypical, molecular, imaging, treatment, and outcome data reflecting the current state of knowledge.

Methods: A retrospective multicenter study of 16 patients with SPTCL that was diagnosed between 1996 and 2016.

Results: The female-to-male ratio was 1.7. The median age at diagnosis was 46.5 years. Patients presented with multiple nodular or plaque-like lesions preferentially affecting the legs and/or trunk. Histopathology typically showed a lobular panniculitis with individual adipocytes surrounded by atypical lymphocytes, usually with a CD3+, CD4-, CD8+, CD56-, TIA1 cytotoxic granule associated RNA binding protein 1-positive phenotype and high proliferation rate. SPTCL was associated with autoimmune diseases in 25% of patients, and with the development of hemophagocytic syndrome in 18% of patients. Oral steroids alone or in combination with low-dose methotrexate or cyclosporine A were the most common initial treatment, achieving a complete response in 85% of the treated patients. The median follow-up time was 14 months. The 5-year disease-specific survival rate was 85.7%.

Limitations: This was a retrospective study.

Conclusions: SPTCL has an excellent prognosis. Immunosuppressive agents can be considered for first-line treatment.

Keywords: cutaneous; subcutaneous panniculitis-like T-cell lymphoma; treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Chemoradiotherapy / methods
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Lymphoma, T-Cell / diagnostic imaging
  • Lymphoma, T-Cell / mortality
  • Lymphoma, T-Cell / pathology*
  • Lymphoma, T-Cell / therapy*
  • Lymphoma, T-Cell, Cutaneous / diagnostic imaging
  • Lymphoma, T-Cell, Cutaneous / mortality
  • Lymphoma, T-Cell, Cutaneous / pathology*
  • Lymphoma, T-Cell, Cutaneous / therapy*
  • Male
  • Middle Aged
  • Panniculitis / diagnostic imaging
  • Panniculitis / mortality
  • Panniculitis / pathology*
  • Panniculitis / therapy*
  • Positron Emission Tomography Computed Tomography / methods
  • Retrospective Studies
  • Risk Assessment
  • Sampling Studies
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy*
  • Spain
  • Survival Analysis
  • Young Adult

Supplementary concepts

  • Subcutaneous panniculitis-like T-cell lymphoma