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Radiological and Clinical Features of Subcutaneous Panniculitis-Like T-Cell Lymphoma

Kim, Jong Woo MD*; Chae, Eun Jin MD*; Park, Young Soo MD; Lee, Hyun Joo MD*; Hwang, Hye Jeon MD*; Lim, Chaehun MD*; Chung, Hye Won MD*

Journal of Computer Assisted Tomography: May-June 2011 - Volume 35 - Issue 3 - p 394-401
doi: 10.1097/RCT.0b013e3182106585
Whole Body Imaging

Objective: To retrospectively analyze computed tomography (CT) and clinical findings of patients with subcutaneous panniculitis-like T-cell lymphoma (SPTCL).

Materials and Methods: The CT findings were retrospectively assessed in 8 patients (6 men, 2 women; age range, 23-60 years; mean age, 39.8 years) with pathologically proven SPTCL. The tumor location, number, distribution, size, and morphological characteristics on CT were evaluated, as were maximum standardized uptake values on positron emission tomography. We also evaluated patient symptoms, laboratory findings, immunophenotype, involvement of bone marrow, treatment, and outcomes.

Results: All 8 patients had multiple (range, 4 to numerous) soft tissue lesions involving subcutaneous fat tissue of the chest, abdominal wall, back, and buttock. Lesions varied in size (range, 0.5-10 cm) and showed reticular (n = 1), nodular (n = 4), and diffuse infiltrative (n = 3) patterns. Three patients had lesions involving the entire thickness of fat tissue, 3 had partial lesions, and 2 had variable lesions. Skin thickening was mild in 4 patients, moderate in 2, and severe in 2; fascia thickening was mild in 3 patients, moderate in one, severe in one, and variable in 2. In 7 patients, lesions were accompanied by engorged supplying vessels. At onset, maximum standardized uptake values varied from 1.2 to 4.7, decreasing to 0.0 to 4.2. Five patients had αβ type and one had γδ type. Clinical outcome varied: two remain alive with disease, two had no disease, and one died.

Conclusions: The SPTCL is characterized by multiple, nodular, or diffuse soft tissue lesions involving subcutaneous fat tissue, accompanied by engorged vessels and skin and fascial thickening. Patients vary in presentation and in treatment outcomes.

From the Departments of *Radiology and Research Institute of Radiology, and †Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Received for publication September 14, 2010; accepted January 7, 2011.

Reprints: Eun Jin Chae, MD, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea (e-mail: ejinchae@amc.seoul.kr, ejinchae@gmail.com).

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (grant no. 2010-0023610).

© 2011 Lippincott Williams & Wilkins, Inc.