Department of Internal Medicine, Abrazo Arrowhead Hospital, Glendale, AZ, USA.
Department of Pathology, Phoenix Pathologists, Banner University Medical Center Phoenix, Pheonix, AZ, USA.
Am J Case Rep. 2021 Jan 11;22:e927142. doi: 10.12659/AJCR.927142.
BACKGROUND Subcutaneous panniculitis-like T cell lymphoma and primary cutaneous γdelta T cell lymphoma are rare forms of non-Hodgkin lymphoma presenting as skin nodules or plaques. CASE REPORT Here, we present a case of a 48-year-old man with multiple subcutaneous, tender, erythematous nodules on his right thigh and left arm. Multiple courses of antibiotics were administered with no significant improvement in the patient's lesions. The skin biopsy report showed CD3/CD8 lymphocytic rimming of the adipocytes and the patient was diagnosed with subcutaneous panniculitis-like T cell lymphoma. A subsequent bone marrow biopsy showed hemophagocytic lymphohistiocytosis. The patient underwent treatment with the cyclophosphamide, hydroxydaunorubicin, Oncovin, prednisone, and etoposide chemotherapy regimen and received an autologous peripheral blood stem cell transplant. CONCLUSIONS Nodular skin lesions can result from a variety of noninfectious causes in addition to bacterial and fungal infections. This case highlights the importance of early biopsy of skin lesions that do not respond to standard therapy to establish an accurate diagnosis and start timely treatment to prevent poor outcomes.
皮下脂膜炎样 T 细胞淋巴瘤和原发性皮肤 γδ T 细胞淋巴瘤是非霍奇金淋巴瘤的罕见类型，表现为皮肤结节或斑块。
本文报道了 1 例 48 岁男性，右大腿和左手臂多处出现皮下、触痛、红斑性结节。患者接受了多轮抗生素治疗，但病变无明显改善。皮肤活检报告显示脂肪细胞周围有 CD3/CD8 淋巴细胞浸润，诊断为皮下脂膜炎样 T 细胞淋巴瘤。随后的骨髓活检显示噬血细胞性淋巴组织细胞增生症。患者接受了环磷酰胺、阿霉素、长春新碱、泼尼松和依托泊苷化疗方案治疗，并接受了自体外周血造血干细胞移植。
除细菌和真菌感染外，结节性皮肤病变还可由多种非传染性原因引起。本病例强调了对标准治疗反应不佳的皮肤病变进行早期活检的重要性，以便做出准确诊断并及时开始治疗，预防不良结局。
