Subcutaneous Panniculitis-like T Cell Lymphoma Diagnosed with a Slowly Progressive Course: A Case Report

Tokai J Exp Clin Med. 2024 Jul 20;49(2):48-52.

Abstract

Panniculitis is an inflammation that occurs in subcutaneous adipose tissue. Panniculitis includes physical panniculitis (e.g., traumatic) and infectious panniculitis (e.g., bacterial, fungal, subcutaneous panniculitis-like T cell lymphoma [SPCTL], etc.). Accurate diagnosis is crucial due to similar clinical presentation of all types of panniculitis. Here, we report a case of SPCTL which was initially diagnosed with traumatic panniculitis. A 15-year-old male patient was admitted to a previous hospital due to a progressively enlarged right flank and inguinal mass after an abdominal bruise. He was initially diagnosed with traumatic panniculitis, but the mass expanded throughout the chest and abdomen accompanied by a fever of over 11 months. Computed tomography (CT) revealed a subcutaneous mass in the anterior chest and abdominal wall. Fludeoxyglucose F18 (FDG) uptake was observed at those lesions using FDG-positron emission tomography (PET). A biopsy of the mass lesion was performed, during which SPCTL was diagnosed based on pathological examination. He was initially treated with prednisolone and cyclosporine A for two weeks. His fever went down, but subcutaneous mass in the chest and abdominal wall persisted. Therefore, he received a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen. After 6 courses of CHOP, CT revealed no disease evidence. He remained in complete remission at 30 months of therapy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Biopsy
  • Cyclophosphamide* / administration & dosage
  • Diagnosis, Differential
  • Disease Progression*
  • Doxorubicin* / administration & dosage
  • Fluorodeoxyglucose F18
  • Humans
  • Lymphoma, T-Cell* / diagnosis
  • Lymphoma, T-Cell* / diagnostic imaging
  • Lymphoma, T-Cell* / pathology
  • Male
  • Panniculitis* / diagnosis
  • Panniculitis* / drug therapy
  • Panniculitis* / etiology
  • Panniculitis* / pathology
  • Positron-Emission Tomography
  • Prednisone / administration & dosage
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vincristine* / administration & dosage

Substances

  • Cyclophosphamide
  • Doxorubicin
  • Vincristine
  • Prednisone
  • Fluorodeoxyglucose F18

Supplementary concepts

  • Subcutaneous panniculitis-like T-cell lymphoma
  • CHOP protocol