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November 1996

Subcutaneous Tissue Involvement by T-Celloma: A Report of 2Cases

Author Affiliations

From the Departments of Pathology (Dr Monterroso), Hematology (Dr Bujan), and Dermatology (Dr Jaramillo), Mexico Hospital, San Jose, Costa Rica; and the Division of Pathology, City of Hope National Medical Center, Duarte, Calif (Dr Medeiros).

Arch Dermatol. 1996;132(11):1345-1350. doi:10.1001/archderm.1996.03890350087014

Background:  T-cellomas may involve the subcsub-tissue as a manifestation of generalized disease.dis-, T-cellomas rarely present with extensive involvement of the subcutaneous fat without other sites of disease.

Observations:  We describe 2women who presented with fever and subcutaneous nodules or masses. In case 1, the nodules were generalized and did not respond to chemotherapy. The patient died 2months after diagnosis. In case 2, the mass was large but localized and responded to chemotherapy. The tumor subsequently recurred in a cervical lymph node 9months later, and the patient was being treated with chemotherapy 15 months after initial diagnosis. Histologically, biopsy specimens from both patients revealed malignant lymphoma involving the subcutaneous tissue. The dermis and epidermis were not involved. At low power the lesions resembled panniculitis, but high-poweron revealed cytologie cytologicgnant lymphoid cells. Immunohistochemical studies revealed T-cellge. In case 2, the neoplastic cells also expressed the Cantigen, were positive for Epstein-Barrand carried the t(2;5)(p23;q35)anslocation. We interpreted case 1as an example of subcutaneous panniculitic T-celloma. We believe that case 2is best classified as anaplastic large cell lymphoma of Tlineage.

Conclusions:  A variety of T-cellomas rarely present with only subcutaneous tissue involvement. Knowledge of this phenomenon and recognition of the cytologicia of the lymphoid cells will help to prevent misdiagnosis.Arch Dermatol. 1996;132:1345-1350

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