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Subcutaneous Panniculitis‐Like T Cell Lymphoma Developing in a Patient with Chronic B‐Cell Lympocytic Leukemia
Author(s) -
Shahabi L,
Schapiro B,
Cotton J
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320gv.x
Subject(s) - medicine , pathology , immunophenotyping , lymphoma , chronic lymphocytic leukemia , erythema nodosum , panniculitis , leukemia , gene rearrangement , leukemia cutis , immunology , bone marrow , biology , biochemistry , flow cytometry , disease , gene
Subcutaneous panniculitis‐like T‐cell lymphoma (SPTCL) is an unusual peripheral lymphoma most typically presenting with a cytotoxic (CD8‐positive, TIA‐1‐positive) immunophenotype. SPTCLs may have an indolent or highly aggressive clinical course. Histologically, SPTCL may be notoriously difficult to diagnosis. Cases of SPTCL with a deceptively benign appearance similar to that of subcutaneous lupus erythematosus have been described. SPTCL associated with a concomitant systemic leukemia/lymphoma has not been documented in the literature. We report a case of SPTCL arising in a 65‐year‐old female with a well‐established history of B‐cell lymphocytic leukemia (BCLL). She presented with two months of recurrent fever and painless erythematous nodules on bilateral lower extremities that were clinically felt to be erythema nodosum. Initial biopsies demonstrated a polymorphous lobular infiltrate with neutrophils, karyorrhexis and lipomembranous change. An excisional biopsy demonstrated an atypical lymphoid population that expressed CD8 and TIA1. PCR analysis confirmed T‐cell receptor gene arrangement. The patient was treated with systemic chemotherapy with resolution of her symptoms and complete remission. This is the first well documented case of SPTCL occurring in a patient with long standing B‐CLL, and highlights the difficulty of establishing an unequivocal diagnosis of SPTCL.