T cell lymphoma presenting clinical and morphological features resembling polymorphic reticulosis and lymphomatoid...

A male, 53 years old, complained of a mass on the left side of neck. The biopsy specimens revealed extensive necrotizing lesions with polymorphonuclear leukocyte infiltration. About three years later a recurrence from the same site was noted and the rebiopsy specimens showed features of malignant lymphoma of pleomorphic type. Subsequently multiple cutaneous nodules and then ulcerative lesions of the midfacial region developed and repeated biopsies were done. Immunological examination indicated that the lymphoid cells obtained from the skin lesion had predominantly T-lymphocyte marker. He died of massive hemorrhage from the nasopharyngeal lesion 51 months after the first admission. Autopsy revealed multiple organ involvements, including the nasopharynx, lungs, subcutaneous tissue, and adrenal gland. The morphological features in the present case were compatible with a diagnosis of lymphomatoid granulomatosis or polymorphic reticulosis (midline malignant reticulosis), and were thought to be best designated as T cell lymphoma.