subcutaneous panniculitis like T cell lymphoma

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  • Clinical

    • median age 35
    • associations: SLE, autoimmune disease
    • subcutaneous nodules commonly extremities and trunk
    • can sometimes get hemophagocytic syndrome
  • Morphology

    • fat infiltration, relative sparing of dermis and epidermis
    • lymphocytes rimming fat cells, variable atypia
    • background vacuolated histiocytes, bean bag cells (macrophages filled with karyorrhectic debris), plasma cells
  • Stains

    • positive: CD8, cytotoxic (granzyme B, perforin, TIA1)
    • negative: CD56
  • Molecular

    • TCR rearrangement (rules out lupus panniculitis)