Subcutaneous Panniculitis-like T-cell lymphoma

ABSTRACT

@#Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of cytotoxic T-cell lymphoma of the skin localized primarily in the subcutaneous adipose tissue. Clinically, the skin lesions mimic lipomas, but histologically resemble panniculitis, which is an inflammation of the subcutaneous fats. Most cases have an excellent prognosis and follow an indolent clinical course with a 5-year overall survival rate of 80%. So far, only a few cases have been reported in the pediatric age group. The diagnosis of SPTCL is based on the combination of clinical presentation, histopathologic examination of the skin lesion, immunohistochemical staining, and molecular analysis. Notably, data on treatment of pediatric SPTCL are even fewer in number, and very few patients undergoing effective treatment have been documented. This is a case report of a 15-year-old female adolescent diagnosed with Subcutaneous panniculitis-like T-cell lymphoma who presented with multiple, non-tender, erythematous to violaceous deep dermal and subcutaneous nodules on the lower extremities associated with myalgia, intermittent moderate-grade fever, and weight loss over the past 7 months. She was initially managed as a case of ―growing pain‖ and acute rheumatic fever, until histopathologic findings of the nodules showed inflammation of the subcutaneous fats, and immunohistochemistry revealed findings consistent with SPTCL. She is currently being treated with multi-agent combination chemotherapy which resulted in improvement of symptoms.