RESUMEN
Atypical lymphocytic lobular panniculitis (ALLP) is a recently described entity characterized by self-limiting plaques that manifest a waxing and waning course. Although ALLP is known as a benign condition, it needs adequate follow-up to determine the risk of progression to subcutaneous panniculitis-like T-cell lymphoma (SPTCL) because ALLP has morphologic and biologic similarities with SPTCL. We report a case of ALLP in a 13-year-old girl who presented with an unusual tumor-like erythematous mass on the left thigh but without systemic symptoms or laboratory abnormalities. The histopathologic findings showed a dense and diffuse infiltration of the fat lobules by small-to-medium-sized atypical lymphocytes including focal atypical mitosis. Some cells showed characteristic peripheral rimming of individual adipocytes. However, prominent lymphoid atypia, fat necrosis, vasculitis, vascular thrombosis, erythrophagocytosis, mucin deposition, and the striking dominance of CD8+ lymphocytes seen in SPTCL were not detected. The lesion resolved spontaneously in 6 months and there was no recurrence over a 24-month follow-up period.
Asunto(s)
Adolescente , Femenino , Humanos , Adipocitos , Necrosis Grasa , Estudios de Seguimiento , Linfocitos , Linfoma de Células T , Mitosis , Mucinas , Paniculitis , Recurrencia , Huelga de Empleados , Muslo , Trombosis , VasculitisRESUMEN
We report here on a 63-year-old woman who presented with recurrent bruise-like infiltrative plaques on the left leg without systemic symptoms or laboratory abnormalities. The histopathologic findings showed an infiltration of panniculus by small to medium-sized atypical lymphocytes. But the prominent lymphoid atypia, fat necrosis, vascular thrombosis, erythrophagocytosis and striking dominance of CD8+ lymphocytes seen in subcutaneous panniculitis-like T-cell lymphoma (SPTCL) were not detected. The diagnosis of atypical lymphocytic lobular panniculitis (ALLP) was made based on these histopathologic and clinical features. The lesions responded well to systemic steroid treatment. But the CD4/CD8 ratio in the later lesion was more decreased than that of the initial lesion, and the patient is under clinical follow up.