Soeshyante Babu*, K Ananth Prabhu, Manvith Kannur and Aneez Sadiq
Subcutaneous Panniculitis-like T-Cell Lymphoma (SPTCL) is a rare and aggressive form of cutaneous T-cell lymphoma that primarily affects the subcutaneous adipose tissue. This study aims to document the clinical presentation, diagnostic challenges and treatment outcomes of SPTCL in a tertiary care hospital setting. Over a period of five years, we reviewed the medical records of patients diagnosed with SPTCL at our institution. The study included a detailed analysis of clinical features, histopathological findings, immunophenotyping and treatment regimens. The majority of patients presented with multiple, painless subcutaneous nodules on the extremities and trunk. Initial misdiagnoses were common, with many patients initially treated for benign conditions such as panniculitis or dermatitis. Histopathological examination revealed dense infiltration of atypical lymphocytes in a lobular pattern, often rimming adipocytes in a lace-like arrangement. Immunophenotyping confirmed the T-cell origin of the lymphoma, with most cases exhibiting a CD4-CD8+ phenotype. Treatment approaches varied, with some patients receiving multiagent chemotherapy regimens, while others were managed with immunotherapy or targeted agents. The study highlights the importance of early and accurate diagnosis, as delayed treatment can lead to significant morbidity and mortality. Despite aggressive therapy, the prognosis of SPTCL remains guarded, with a subset of patients experiencing relapse or progression of the disease. In conclusion, SPTCL is a rare but serious condition that requires a high index of suspicion for early diagnosis and prompt initiation of appropriate treatment. This study underscores the need for increased awareness among clinicians and the importance of multidisciplinary management to improve outcomes for patients with this challenging lymphoma.
