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Report of Two Additional Cases and Further Observations

Charles Perniciaro, MD; Mark J. Zalla, MD; John W. White, Jr, MD; David M. Menke, MD

Arch Dermatol. 1993;129(9):1171-1176.

Abstract
Background
Peripheral T-cell lymphomas involving subcutaneous tissue are rare. With modern immunohistochemical stains, subcutaneous T-cell lymphomas may be demonstrated in patients previously thought to have fatal Weber-Christian disease, malignant histiocytosis, and histiocytic cytophagic panniculitis.

Observations
We describe two young women with subcutaneous lymphomas. They presented with erythematous nodular lesions, which suggested benign panniculitis. Skin biopsy specimens in both patients demonstrated large atypical lymphocytes in the subcutaneous tissue, karyorrhexis, and cytophagia. Immunohistochemical studies confirmed a T-cell phenotype. Molecular genetics studies performed in one patient showed a major T-cell clonal population.

Conclusions
Subcutaneous T-cell lymphoma is a rare, distinct subtype of postthymic peripheral T-cell lymphoma. Cytophagic "histiocytic" panniculitis is frequently a prominent histologic feature. Early systemic chemotherapy may offer therapeutic advantages in patients with this disease.

(Arch Dermatol. 1993;129:1171-1176)

Author Affiliations
From the Department of Dermatology (Drs Perniciaro, Zalla, and White) and the Department of Pathology (Dr Menke), Mayo Clinic Jacksonville (Fla).

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