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Histopathologic examination of the skin biopsy specimen demonstrated heavy infiltrates of monomorphous atypical lymphoid cells rimming individual adipocytes, apoptosis, karyorrhexis, and areas of angiocentrism and neurotropism (accounting for the hypoesthesias). On immunohistochemical analysis, the lymphocytes were strongly positive for CD45RO and negative for CD20. Bone marrow analysis was performed and revealed leukoerythrophagocytosis by macrophages. The histopathologic features of the case were consistent with the diagnosis of malignant lymphoma involving the subcutis and specifically with SPTCL.
Fever and Necrotic Nodules on the Extremities—Diagnosis. Arch Dermatol. 2005;141(8):1035-1040. doi:10.1001/archderm.141.8.1035-e