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Clinical question
A 38-year-old female presents to the dermatology clinic with the complaint of barely visible ‘lumps’ on the upper arms and anterior chest wall. She has had these developing slowly over the last year. Her face appears normal. A biopsy was taken from the right forearm.
Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2016-204009/ and consider your diagnosis.
What is the correct diagnosis?
A. Dermatomyositis
B. Lupus profundus
C. Polyarteritis nodosa
D. Pyoderma gangrenosum
E. Subcutaneous panniculitis like T cell lymphoma
The correct answer is after the discussion.
DISCUSSION
Subcutaneous panniculitis-like T cell lymphoma (SPTCL) is a rare cytotoxic T cell lymphoma that accounts for <1% of non-Hodgkin lymphomas. It occurs in males and females equally. It has a broad age range, although it is more common in young adults. The aetiology is unknown.1 The tumour commonly presents as subcutaneous nodules of the extremities and trunk, ranging from 0.5 cm to several centimetres in diameter.2 Lymphadenopathy and hepatomegaly are usually absent.
On biopsy, the tumour involves the …
Footnotes
Handling editor Iskander Chaudhry.
Contributors All authors contributed equivalently to the manuscript.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Commissioned; internally peer reviewed.