POSTER'13'
SUBCUTANEOUS'PANNICULITIS'LIKE'T'CELL'LYMPHOMAIA'CASE'SERIES'
'
Steffi!Chacko1,!Dr.Geetha!N1,!Dr.Sreejith!Nair1,!Dr.Prakash!N!P1!and!Priya!Mary!Jacob2!
!
(1)Department! of! Medical! Oncology,! Regional! Cancer! Centre,! Thiruvananthapuram,! India,!
(2)Department!of!Pathology,!Regional!Cancer!Center,!Thiruvananthapuram,!India!
!
Subcutaneous! panniculitis! like! T! cell! lymphoma! (SPTCL)! is! an! extremely! rare! entity!
constituting!less!than!1%!of!all!lymphomas.!It!presents!as!painless!nodular!lesions!localised!
primarily!to!the!subcutaneous!tissue!involving!the!extremities,!trunk!and!abdominal!wall.!At!
presentation!SPLTCL,!closely!mimics!benign!condition!like!panniculitis,!cellulitis,!skin!and!soft!
tissue! infections,! hence! poses! a! diagnostic! challenge.! Here! we! report! a! case! series! of! 6!
patients!diagnosed!with!SPTCL.!
AIM:!To!study!the!clinical!characteristics,!treatment!and!survival!of!patients!diagnosed!with!
SPTCL.!
MATERIALS'AND'METHODS:!
This!is!a!retrospective!study!conducted!in!patients!diagnosed!with!SPTCL!in!the!department!
of!medical!oncology!at!Regional!Cancer!Centre,!Trivandrum!during!last!10!year!period.!The!
medical! records! of! these! patients! were! studied! and! data! regarding! clinical! presentation,!
diagnostic/staging!work!up!and!treatment!were!collected!and!survival!data!obtained.!
RESULTS!
Among!the!6!patients!diagnosed!with!SPTCL,!there!were!5!females!and!1!male!patient.!The!
median!age!at!presentation!was!24!years!(16J78!years).!All!patients!presented!with!typical!
nodular! subcutaneous! skin! lesions.! Three! patients! presented! with! generalized! skin! lesions!
involving! abdomen,! limbs! and! chest! wall.! While! remaining! three! patient! presented! with!
localized! skin! involvement! limited! to! the! gluteal! and! anterior! abdominal! wall,! thigh! and!
breast!region!respectively.!Persistent!fever!and!B!symptom!were!documented!in!4!out!of!6!
patients.!One!patient!was!diagnosed!and!treated!for!macrophage!activation!syndrome!prior!
to!diagnosis!of!SPTCL.!One!patient!had!presented!with!relapsed!SPTCL!after!a!disease!free!
interval! of! 9! years.! The! diagnosis! was! confirmed! with! excision! biopsy! of! subcutaneous!
nodule! and! histopathology! revealed! atypical! lymphoid! cells! with! immunohistochemistry!
positive!for!T!cell!markers!CD3!,!CD8!and!granzyme!in!all!patients.!Three!patients!with!newly!
diagnosed! SPTCL! were! treated! with! CHOP! (Cyclophosphamide,! Vincristine,! Doxorubicin,!
Prednisolone)!chemotherapy!for!6!cycles.!One!patient!who!presented!with!relapsed!SPTCL!
received! salvage! chemotherapy! with! DHAP! protocol.! Palliative! chemotherapy! with! EP! (!
Cyclophosphamide,!prednisolone)!was!started!in!one!elderly!patient!with!poor!performance!
status.!One!patient!with!disease!localized!to!thigh!received!radiotherapy!(45!Gy)!in!addition!
to!CHOP!chemotherapy!for!4!cycles.!End!of!treatment!evaluation!was!suggestive!of!complete!
remission! (CR)! in! 4! patients.! One! patient! progressed! immediately! after! 6th!cycle! of!
chemotherapy!while!one!patient!died!while!on!chemotherapy.!At!2!years!4!patients!(66%)!
are!alive!in!CR!and!at!5!year!3!patients!(50%)!are!alive!in!remission.!
! !
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES