Subcutaneous panniculitis-like T cell lymphoma

A 22-year-old female presented with erythematous tender nodules on trunk and limbs for 6 weeks and associated fever, malaise, and loss of appetite for 2 weeks. She had a high ESR, leukopenia, and thrombocytopenia.

Histological examination revealed lobular panniculitis with atypical lymphocytic infiltrate. Cytophagocytic histiocytes were not seen. Immunohistochemical studies confirmed a T cell phenotype.

Subcutaneous panniculitis-like T cell lymphoma (SPTCL) was diagnosed. Chemotherapy was commenced, and the initial response was satisfactory.

T cell lymphoma, though rare, has to be included in the differential diagnosis of subcutaneous nodules. Increased awareness of this rare disease would help in early diagnosis of this non-specific common presentation.