Hodgkin lymphoma (HL), although a common hematopoietic malignancy, presents as a primary cutaneous form in extraordinarily rare instances. In this study, we present a remarkable case of a 76-year-old woman with a history of bony metastatic breast cancer who developed multiple subcutaneous nodules on the left neck and scalp. A biopsy revealed the histological and immunohistochemical findings of classic HL. She was treated with systemic chemotherapy and quickly achieved disease remission. Five months later, she was alive and without evidence of lymphoma, consistent with our understanding of primary cutaneous HL as an indolent variant of HL.
Background: Primary cutaneous T cell lymphoma is a diverse and rare group of diseases with clinical manifestations that, if not biopsied, are easily confused with benign skin diseases.
Objective: To determine some clinical features of primary cutaneous T cell lymphomas and classify them according to the 2018 update of World Health Organization and European Organisation for Research and Treatment of Cancer classification.
Methods: a case series study with 39 cases of primary cutaneous T cell lymphomas diagnosed at Pathology Department of University Medical Center at Ho Chi Minh city from 01/2018 to 02/2022.
Results: Median age at diagnosis is 59 years old. Male:Female ratio is 1:2.3. In order of frequency, diagnoses were: subcutaneous panniculitis-like T cell lymphoma (35.8%), mycosis fungoides (28.2%), primary cutaneous anaplastic large cell lymphoma (15.4%), peripheral T cell lymphoma not otherwise specified (7.7%), extranodal NK/T cell lymphoma, nasal type (7.7%), primary cutaneous CD4+ small/medium T cell lymphoproliferative disorder (2.6%) and primary cutaneous CD8+ aggressive epidermotropic T- cell lymphoma (2.6%). Subcutaneous panniculitis-like T cell lymphoma always presents as subcutaneous nodule-tumor (100%); the most common site is lower extremities (71.4%). Mycosis fungoides has various appearance of skin lesions (36.4%) including patch-plaque (100%), and usually involves in trunk (90.9%). Extranodal NK/T cell lymphoma, nasal type always has skin ulcer (100%).
Conclusion: The study documented the frequence and clinical characteristics of each subtype of primary cutaneous T cell lymphoma. The most common were subcutaneous panniculitis-like T cell lymphoma and mycosis fungoides. Although the morphology and location of skin lesions in the subtypes overlap, they still aid in the diagnosis of skin lymphoma.
Key words: T-cell lymphoma, primary, cutaneous.
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