Cutaneous gamma-delta T-cell lymphoma is similar to subcutaneous panniculitis-like T-cell lymphoma (SPTCL) but is an aggressive disorder that responds poorly to aggressive chemotherapy.


Clinical features:

(1) B-symptoms (fever, chills, night sweats, weight loss) common

(2) disseminated plaques and ulceronecrotic nodules

(3) cytopenias are common

(4) an autoimmune disorder is common

(5) many patients develop the hemophagocytic syndrome (HPS)

(6) absence of lymphoma in lymph nodes or other extracutaneous sites

(7) the prognosis is poor


Pathologic features:

(1) medium to large lymphocytes with nuclear pleomorphism infiltrate the subcutaneous tissue (panniculitis) and extend into the dermis

(2) extensive necrosis is present

(3) apoptosis is marked

(4) angioinvasion


Immunoperoxidase staining:

(1) CD3 positive and CD4 negative

(2) CD8 negative

(3) CD30, CD56 and TCR-delta positive


Differential diagnosis:

(1) cutaneous T-cell lymphoma with alpha-beta T-cell receptors (SPTCL)

(2) other forms of panniculitis


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