Subcutaneous panniculitis-like T-cell lymphoma invading central nervous system in long-term clinical remission with lenalidomide: A case report

Abstract

BACKGROUND Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) involvement in the central nervous system (CNS) is particularly rare. SPTCL with CNS involvement has an exceedingly poor prognosis, and no optimum therapeutic method has been discovered. To the best of our knowledge, this is the first reported case of SPTCL invading the CNS achieving long-term remission with lenalidomide maintenance therapy. CASE SUMMARY A 63-year-old man diagnosed with SPTCL was admitted to the hospital with severe headache for 15 d after four cycles of chemotherapy. Subsequent to the treatment, the patient developed CNS involvement. Craniotomy biopsy was pathologically diagnosed as CNS T-cell lymphoma, and two courses of chemotherapy were performed postoperatively. Due to the intolerance of the side effects of chemotherapeutic drugs, the patient received lenalidomide instead. The magnetic resonance imaging of the head at the 8 mo follow-up indicated no signs of recurrence, and the vital signs were stable. CONCLUSION Lenalidomide deserves further investigation as a targeted drug for SPTCL cases involving the CNS.

CD20-positive subcutaneous panniculitis-like T-cell lymphoma presenting as polycranial neuropathy: A CARE-compliant case report and literature review

“…[ 26 ] Cranial magnetic resonance imaging did not detect any intraparenchymal lesions, and cerebrospinal fluid examination revealed lymphomatous leptomeningeal involvement. Jing Sun et al reported a case of SPTCL after chemotherapy that developed CNS involvement; [ 10 ] a craniotomy biopsy showed CNS T-cell lymphoma, and TCR gene rearrangement showed TCR-β and TCR-γ clonal rearrangement. One SPTCL case developed Epstein-Barr virus-associated CNS B-cell lymphoma after alemtuzumab-CHOP treatment.…”

“…The involvement of the central nervous system (CNS) in the SPTCL is rare. [ 9 , 10 ] We present a case of SPTCL beginning as polycranial neuropathy that presented in a single anatomic site and a single skin lesion that involved the CNS and discuss clinical characteristics, immunohistochemical features, and literature review on SPTCL.…”

“…[5][6][7] As the disease progresses, the lesions gradually expand, measure from 0.5 cm to more than 10 cm, [5][6][7] and even involve intra-abdominal fat, [5] lung, [8] bone marrow, [8] cerebrum. [9,10] In addition, there are some differences in the immunohistochemical staining of the tumors. The involvement of the central nervous system (CNS) in the SPTCL is rare.…”