Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Subcutaneous Panniculitis-Like T-Cell Lymphoma
- Radiologic Findings
- Fig 1~4. Axial CT image shows infiltrative lesions within subcutaneous fat tissue in the anterior, posterior chest wall and abdominal wall. Lesions involve the entire depth of the fat layer and there is an engorged vessel supplying the lesion.
Fig 5. FDG-PET image shows hypermetabolism in the area of lesions of left anterior chest wall.
- Brief Review
- Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous lymphoma and belongs to a new subset of peripheral TCL, as determined by the World Health Organization (WHO). Patients usually present with subcutaneous nodules that resemble panniculitis both clinically and pathologically. The SPTCL lesions can be easily assessed using various imaging modalities, such as ultrasonography (US), CT, magnetic resonance imaging, and positron emission tomography (PET). Skin biopsies, however, are required because the diagnoses of lesions might be overlooked.
Patients with SPTCL presented with multifocal, disseminated, nodular, or diffuse soft tissue lesions located within subcutaneous fat tissue of the trunk
and extremities. These lesions varied in shape, margin, and depth of involvement and were often accompanied by engorged supplying vessels and thickening of the skin and fascia. These distinct CT findings may help in the clinical diagnosis of SPTCL in patients with nonspecific symptoms and signs.
Histologically, SPTCL is characterized by a lymphohistiocytic infiltrate confined primarily to the interstitium of fat lobules in a pattern resembling lobular panniculitis. Lymphoid cells tend to surround individual adipocytes and have a characteristically rimmed appearance.13,20 Although predominantly located within the subcutis, focal extension into the deep to midreticular dermis often occurs, usually in a perivascular or periadnexal distribution.
- References
- 1. JW Kim, et al. Radiological and clinical features of subcutaneous panniculitis-like T-cell lymphoma. J Comput Assist Tomogr. 2011 May-Jun;35(3):394-401.
- Keywords