
Latent Epstein-Barr Virus Infection Is Frequently Detected in Subcutaneous Lymphoma Associated With Hemophagocytosis but Not in Nonfatal Cytophagic Histiocytic Panniculitis-Reply
L. Jeffrey Medeiros, MD
Division of Pathology City of Hope National Medical Center 1500 E Duarte Rd Duarte, CA 91010-0269
Victoria Monterroso, MD
San Jose, Costa Rica
Arch Dermatol. 1997;133(6):788.
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We thank Iwatsuki and colleagues for their interest in our article.1 The goal of our study was to make the point that different types of T-cell lymphoma may initially present with involvement of subcutaneous tissue, of which a subset of cases are examples of subcutaneous panniculitic T-cell lymphoma. This view is shared by others, such as Burg et al.2 To illustrate our point we reported 2 cases. Patient 1 in our study was a woman who presented with multiple, nonulcerated, subcutaneous plaques associated with clinical and laboratory evidence suggestive of a hemophagocytic syndrome. Results of immunohistochemical studies revealed T-cell lineage without CD30 antigen expression. No evidence of Epstein-Barr virus (EBV) infection was detected using in situ hybridization methods to detect EBV RNA. The patient died 2 months after beginning chemotherapy. We interpreted this case as an example of subcutaneous panniculitic T-cell lymphoma. Patient 2 in our study was
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