RESUMO
Nodular fasciitis is one of the more common soft-tissue lesions, frequently presenting as a rapidly enlarging subcutaneous mass on the arm. Management is usually surgical excision; however, large infiltrative lesions may be difficult to manage. We describe a patient in whom intralesional corticosteroid injections provided rapid resolution.
Assuntos
Fasciite/tratamento farmacológico , Glucocorticoides/uso terapêutico , Triancinolona Acetonida/uso terapêutico , Adulto , Fasciite/patologia , Feminino , Antebraço , Glucocorticoides/administração & dosagem , Humanos , Injeções Intralesionais , Resultado do Tratamento , Triancinolona Acetonida/administração & dosagemAssuntos
Credenciamento , Dermatologia , Privilégios do Corpo Clínico , Acreditação , Adulto , Alergia e Imunologia/educação , Certificação , Criança , Currículo , Dermatologia/classificação , Dermatologia/educação , Docentes de Medicina , Cirurgia Geral/educação , Humanos , Internato e Residência/organização & administração , Patologia/educação , Pesquisa , Dermatopatias/diagnóstico , Dermatopatias/terapia , Conselhos de Especialidade ProfissionalAssuntos
Anti-Inflamatórios/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Dermatopatias/tratamento farmacológico , Administração Cutânea , Idoso , Anti-Inflamatórios/administração & dosagem , Criança , Fármacos Dermatológicos/administração & dosagem , Glucocorticoides , Humanos , LactenteAssuntos
Alopecia/terapia , Alopecia/diagnóstico , Alopecia/patologia , Feminino , Humanos , MasculinoRESUMO
We report a case of subcutaneous T-cell lymphoma that presented as recurrent subcutaneous nodules, pancytopenia, and fever. Histopathologic examination revealed a dense infiltrate of markedly atypical lymphoid cells localized to the panniculus. These cells were identified as T cells by immunohistochemistry. There was associated karyorrhexis and fat necrosis. Hemophagocytosis was present both in the panniculus and in the bone marrow, with no tumor evident outside the subcutaneous tissue. Despite chemotherapy in conjunction with an autologous bone marrow transplant, the patient died after metastases, including explosive leukemic transformation, developed. Review of the literature shows subcutaneous T-cell lymphoma to be a rare peripheral T-cell lymphoma, often mistaken initially as a benign panniculitis, that manifests an aggressive, fulminant presentation in approximately one half of the patients; the remainder transform into a high-grade malignancy after months to years. The hemophagocytic syndrome, though to be a reactive T-cell process mediated by cytokines, is a frequent complication of this lymphoma and is responsible for its poor prognosis. Our patient uniquely demonstrated fatal leukemic transformation.