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J Am Acad Dermatol ; 79(5): 892-898, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30126736

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.


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