Systemic panniculitis‐like T‐cell lymphoma with involvement of mesenteric fat and subcutis

Subcutaneous panniculitis‐like T‐cell lymphoma (SPTCL) is an uncommon non‐Hodgkins primary cutaneous lymphoma that typically presents as subcutaneous nodules on the extremities or trunk. Here, we report an unusual case of systemic panniculitic T‐cell lymphoma with predominantly mesenteric extra‐cutaneous involvement and an aggressive clinical course with histopathologic and immunophenotypic features that mimic SPTCL. This case serves to expand the body of literature regarding systemic SPTCL‐like disorders with prominent extra‐cutaneous involvement.     

Composite cutaneous lymphoma of diffuse large B‐cell lymphoma‐leg type and subcutaneous panniculitis‐like T‐cell lymphoma

Composite lymphoma (CL) is a rare disease defined by the occurrence of two distinct lymphomas within a single tissue at the same time. We present the case of an 89‐year‐old male with a clinical history of immunoglobulin M monoclonal gammopathy of undetermined significance. The patient presented cutaneous eruption of nodules on the right bottom and arm. An excisional biopsy revealed cutaneous infiltration composed of two components. The first one consisted of large B‐cells with CD20+/MUM1+/BCL2+ phenotype whereas the second one involved the subcutaneous fat in a panniculitic manner, and was CD3+/CD8+/granzyme B+/TCRβF1+. The final diagnosis was CL of primary cutaneous large B‐cell lymphoma‐leg type (PCLBCL‐leg type) and subcutaneous panniculitis‐like T‐cell lymphoma (SPTCL). We report and characterize for the first time coexistent PCLBCL‐leg type and SPTCL in a patient.     

Subcutaneous panniculitis‐like T cell lymphoma presented as erythema nodosum: A case report

Subcutaneous panniculitis‐like T cell lymphoma (SPTCL) is an extremely rare subtype of primary cutaneous T cell lymphomas mimicking panniculitis. Clinically, patients are usually presented with subcutaneous nodules, which usually leads to initial misdiagnosis as a benign cutaneous condition. Here, we report a 40‐year‐old female who presented with subcutaneous erythematous nodules on her extremities with fever. On the basis of the clinical presentations, histopathological features and immunohistochemical findings, a diagnosis of SPTCL was made. The patient was treated with the injection of recombinant human interferon α‐1b (30 μg) every other day for 3 months. The lesions gradually regressed. No new erythema nodules reappeared during the 10‐month follow‐up.     

Oral bexarotene for post‐transplant cutaneous T‐cell lymphoma

Organ transplant recipients receiving immunosuppression have an increased risk of developing post‐transplant lymphoproliferative diseases (PTLDs). Traditionally, PTLDs refer to Epstein‐Barr virus (EBV)‐induced B‐cell lymphoma. However, post‐transplant T‐cell lymphoma may also occur and tends to have a poorer response to reduced immunosuppressive therapy. As such, additional therapy is often needed for post‐transplant T‐cell lymphoma, including post‐transplant cutaneous T‐cell lymphoma (PT‐CTCL). We present only the third case of PT‐CTCL occurring after liver transplantation. The patient was diagnosed with stage IB mycosis fungoides (MF). His lesions were refractory to multiple skin‐directed therapies, and so he was given oral bexarotene 150 mg daily and his oral tacrolimus dose was decreased to 2 mg daily. Remarkably, his MF patches have demonstrated a complete response to oral bexarotene 75 mg daily without recurrence over 11 years of follow‐up. He developed hypertriglyceridemia with bexarotene 150 mg, so his dose was decreased to 75 mg, without loss of response. Our report is the second to describe PT‐CTCL demonstrating a long‐term complete response to oral bexarotene. Given its anti‐carcinogenic properties and favorable toxicity profile, oral bexarotene represents an appealing treatment option for PT‐CTCL refractory to skin‐directed therapies.