It was with great interest that I read the article by Perniciaro et al1 on subcutaneous T-cell lymphoma. The authors made some statements on which I would like to comment.
The authors are correct in pointing out that there are two distinct clinical presentations, one characterized by a protracted course of recurrent self-healing subcutaneous nodules and another by a clinical course that rapidly progresses.
However, there seem to be additional subtypes that should not be intertwined. The cases reported by Gonzalez et al2 and us3 differ in many respects, such as delta-positivity, lack of cytophagia, production of interferon gamma, and slow progression of disease. In the case we reported, death, indirectly related to the lymphoma (leukopenia, fever), occurred within 5 years.3
In conclusion, the subcutaneous localization of the infiltrate, by itself, is not a distinct feature characterizing a nosologic subtype of lymphoma but a histologic phenotype,
Burg G, Dummer R, Nestle F. Distinct Subtypes of Subcutaneous T-cell Lymphoma. Arch Dermatol. 1994;130(8):1073. doi:10.1001/archderm.1994.01690080143025