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Panniculitis-like T-cell lymphoma clinically manifested as alopecia
L Török1, T P Gurbity, A Kirschner
1Department of Dermatology, County Hospital, Nagykörösi u. 15, 6000 Kecskemét, Hungary. laszlo.a.torok@matavnet.hu
The British Journal of Dermatology
|October 9, 2002
Summary
A rare T-cell lymphoma mimicking alopecia areata presented with isolated scalp lesions. Gene rearrangement confirmed subcutaneous panniculitis-like T-cell lymphoma after a long, indolent course.
Area of Science:
- Dermatopathology
- Oncology
- Immunology
Background:
- Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare cytotoxic T-cell lymphoma.
- SPTCL often presents with systemic symptoms and characteristic skin lesions.
Observation:
- A 45-year-old woman presented with multifocal scalp lesions initially diagnosed as alopecia areata.
- Initial histopathology suggested cytophagic histiocytic panniculitis, with T-cell lymphoma as a differential diagnosis.
- The patient exhibited an indolent clinical course over 20 months.
Findings:
- T-cell receptor gamma-chain gene rearrangement confirmed the diagnosis of subcutaneous panniculitis-like T-cell lymphoma.
- The case demonstrated an unusual isolated scalp manifestation of SPTCL.
- The lymphoma followed an indolent clinical course.
Implications:
- This case highlights the importance of considering SPTCL in scalp lesions that mimic other dermatological conditions.
- Diagnostic delays can occur due to the subtle presentation and initial misdiagnosis.
- Early and accurate diagnosis through molecular techniques like gene rearrangement is crucial for appropriate management of SPTCL.