Important points to remember about this
like T-cell lymphoma
a rare form of non-Hodgkin lymphoma infiltrating into subcutaneous
adipose tissue. It belongs to the group of primary cutaneous T-cell
This is an aggressive
tumour and usually affects patients in the 4th decade of life. Some
cases have been reported in children.
According to literature
review this lesion is more common in female.
Clinically, the lesions
present as painful, reddish brown, often ulcerated nodules.
These are usually
located on the legs. Cases have been reported in other locations like
trunk, arms, axilla and face.
Patient complains of
fever, loss of weight and myalgia.
lymphoma derived from α/β T-cells, is a
more aggressive form of lymphoma.
Histologically, the lesion is characterized by lobular lymphocytic
- The lymphomatous cellular
infiltrate is composed of small, medium and large lymphocytes with
irregular hyperchromatic nuclei.
- The atypical cells distribute
between individual adipose lobules, proliferating and forming a
"ring" around adipocytes. In the scanning power the lesion has a
- Apoptotic cells and fat necrosis
with foamy cells are present in almost all cases.
- "Bean-bag histiocytes" are large
phagocytic histiocytes containing cell debris or red blood cells.
These are present in many cases.
histiocytic panniculitis is a rare disease. It was first described
in 1980. It is characterized by infiltration of subcutaneous adipose
tissue by benign-appearing T - lymphocytes and phagocytic
histiocytes ("bean bag cells"). Cytophagic histiocytic panniculitis
may be an isolated skin disease or associated with non-malignant
conditions, such as infections, as well as malignancies, including
subcutaneous panniculitis-like T-cell lymphoma.
- Plasma cells are noted in some
cases but eosinophils and neutrophils are usually absent.
The cells of
like T-cell lymphoma are T-cells. CD3 is widely used marker since it is
never found on B cells.
TCR is also T-cell specific. These are
occasionally lost by neoplastic T cells, so that alternative markers
such as CD43 or CD45RO, although not specific for T-Cells, may be of
However these antigens are also found in some B
cell lymphomas and can be expressed by macrophages and myeloid cells.
CD8 is specific for cytotoxic/suppressor cells. TIA-1, granzyme B,
perforin are markers of Cytotoxic T cells.
Pathology of Pagetoid reticulosis
Pathology of Lymphomatoid Papulosis - Cells
resembling 'chunks of coal'
Pathology of Primary Cutaneous Anaplastic Large
Pathology of Cutaneous B-Lymphoblastic
Pathology of Intravascular
Large B-cell Lymphoma
Pathology of Primary Cutaneous Marginal Zone B-Cell
Pathology of Primary
Cutaneous Diffuse Large