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Weekly Chest CasesArchive of Old Cases

Case No : 1099 Date 2018-11-19

  • Courtesy of Eun Jin Chae, MD / University of Ulsan College of Medicine, Asan Medical Center
  • Age/Sex 31 / M
  • Chief Complaintfever, chilling sense
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

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
Keywords

No. of Applicants : 76

▶ Correct Answer : 51/76,  67.1%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Niigata University , Japan ATSUSHI UEHARA
  • - Higashi-Ohmi General Medical Center , Japan AKITOSHI INOUE
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - Ajou University School of Medicine , Korea (South) JUNG YONG JUN
  • - Chonbuk National University Hospital , Korea (South) MINGI SHIN
  • - McGill University Health Center , Canada Alexandre Semionov
  • - , Canada ASHISH GUPTA
  • - Chonbuk National University Hospital , Korea (South) SANGHEON KIM
  • - Chonbuk National University Hospital , Korea (South) EUN HA JUNG
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) HEE SEOK CHOI
  • - 罹…stanbul , Turkey AYHAN YILMAZ
  • - The Jikei university , Japan TAKU GOMI
  • - Ajou University Hospital , Korea (South) Taeyang Ha
  • - Seoul National University Hospital , Korea (South) HYOUNG IN CHOI
  • - Fujieda Municipal General Hospital , Japan HAYATO NOZAWA
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Asan Medical Center , Korea (South) JAE WOO SONG
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Seoul National University Hospital , Korea (South) JI HEE KANG
  • - Samsung Medical Center , Korea (South) MIN YEONG KIM
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Chonbuk National University Hospital , Korea (South) YOUNGKWANG LEE
  • - Ewha Womans University Medical Center , Korea (South) YOUNGSUN KO
  • - Ajou University Hospital , Korea (South) DAYOUNG KIM
  • - CLINIQUE STE CLOTILDE , Reunion PATRICK MASCAREL
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Ajou University Hospital , Korea (South) HYERIN KIM
  • - Chungbuk national university hospital , Korea (South) Miran Yeon Yeon
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - Multimagem Diagn泥˜sticos , Brazil PEDRO PAULO TEIXEIRA E SILVA TORRES
  • - , Korea (South) JANG SEONG WON
  • - Columbia asia refferal hospital,Bengaluru , India PRAVIN KUMAR M
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - Samsung Medical Center , Korea (South) JEONGHYUN LEE
  • - Chonbuk National University Hospital , Korea (South) SOL KI KIM
  • - Ajou University Hospital , Korea (South) SUBIN HEO
  • - Teikyo University Hospital , Japan KAORU SUMIDA
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
  • - Kyoto Prefectural University of Medicine , Japan TADASHI TANAKA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
  • - Samsung Changwon Hospital , Korea (South) DONG SU KIM
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - Seoul Veterans Hospital , Korea (South) HYUN JUNG YOON
  • - Ajou University Hospital , Korea (South) YOO YOUNGJIN
▶ Correct Answer as Differential Diagnosis : 13/76,  17.1%
  • - Showa university Northern Yokohama Hospital , Japan KOTA WATANABE
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - , United Kingdom SAMSON K
  • - Other , Korea (South) SEONGSU KANG
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - , Japan NAOMI YUASA
  • - Korea University Guro Hospital , Korea (South) KYU-CHONG LEE
  • - Chonnam National University Hwasun Hospital , Korea (South) JONG EUN LEE
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Jiangsu province hospital , China WANGJIAN ZHA
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Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Eun Jin Chae, MD, PhD. Email:ejinchae@gmail.com

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