Brawny cutaneous induration and granulomatous panniculitis in large cell non-Hodgkin's (T suppressor/cytotoxic cell) lymphoma.
A 56-year-old lady presented with striking peau d'orange-like, woody, diffuse infiltration of the skin of the upper, inner aspects of both arms and thighs. Initial biopsy specimens showed a granulomatous panniculitis with non-specific lymphohistiocytic infiltration. Clinical deterioration occurred with development of ascites and peripheral oedema; a single axillary node became palpable. Cytology of ascitic fluid, and histology and immunopathology of the axillary node, and of a further skin biopsy, now revealed diagnostic changes of a diffuse large cell lymphocytic lymphoma of T suppressor/cytotoxic type. Granulomatous panniculitis resulting in diffuse cutaneous infiltration may rarely be a presenting sign of malignant lymphoma.
Ashworth
J
J
Department of Medicine, Dermatology, Charing Cross and Westminster Medical School, London, U.K.
Coady
A T
AT
Guy
R
R
Breathnach
S M
SM
D001132:Arm; D005260:Female; D006099:Granuloma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007868:Leg Dermatoses / Q000209:etiology* / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D015434:Panniculitis / Q000209:etiology* / Q000473:pathology; D013601:T-Lymphocytes; D013602:T-Lymphocytes, Cytotoxic