A 9-month-old girl was evaluated for recurrent fevers, rash, and indurated plaques, with laboratories demonstrating hyperferritinemia, hypertriglyceridemia, and pancytopenia, concerning for hemophagocytic lymphohistiocytosis. Biopsy of thigh lesion ultimately demonstrated subcutaneous panniculitis-like T-cell lymphoma. In a rare neoplasm of cytotoxic T-cells, subcutaneous panniculitis-like T-cell lymphoma presents with subcutaneous nodules in all age groups including children. Prognosis is generally good with immunosuppressive drugs being first line of treatment. 18F-FDG PET/CT demonstrates hypermetabolic lesions and is used to determine the extent of disease burden, identify sites of occult disease, and assess response to treatment.
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