Subcutaneous panniculitis-like T-cell lymphoma in pregnancy

A young pregnant woman in her 20s presented with a 2 month history of high-grade intermittent fever. She exhibited multiple painful nodules scattered across her body for 2 months, initially small but progressively increasing in size. Initially diagnosed with Sweet syndrome, a skin biopsy revealed subcutaneous panniculitis-like T-cell lymphoma, confirmed through immunohistochemistry analysis. Treatment started with antibiotics and antipyretics. Upon ruling out septicaemia, steroid therapy was initiated, resulting in an immediate reduction in fever and rash. However, 2 months post-diagnosis, new lesions emerged, prompting a trial of dapsone, which led to their complete resolution without residual evidence. Subsequently, the case was transitioned to the obstetrician for safe management during parturition. Postpartum imaging unveiled multiple subcutaneous thickenings in the anterior and posterior abdominal walls, anterolateral portion of the right thigh and left perineal regions. After delivery, she was referred to medical oncology due to the emergence of new lesions.