1/21. A case of natural killer/T cell lymphoma of the subcutis resembling subcutaneous panniculitis-like T cell lymphoma.A case of nasal type natural killer (NK)/T cell lymphoma of the subcutis showing clinical and morphological features that resemble subcutaneous panniculitis-like T cell lymphoma (SPTCL) is presented. A 73-year-old man presented with swelling of the left arm and was diagnosed with panniculitis by a dermatologist. It was concluded from a skin biopsy specimen that the patient had non-Hodgkin's lymphoma of the large cell, NK/T cell type because the neoplastic cells showed polyclonal CD3 immunoreactivity. Treatment with interferon-gamma was initiated, but the patient died of disseminated intravascular coagulation and multiple organ failure 2 months after the initial symptoms appeared. However, involvement of additional organs by the lymphoma was not apparent clinically. An autopsy was not performed. A routinely stained section of the biopsy skin specimen revealed massive necrosis of the subcutaneous fat, karyorrhexis admixed with reactive histiocytes, and large atypical lymphoid cells. Immunoreactivity for polyclonal CD3 was present in the perinuclear region, but absent in the neoplastic cell membranes. CD56, CD45RO (UCHL-1), CD43 (MT1), CD45 (leukocyte common antigen), and the cytotoxic molecules perforin, granzyme B and TIA-1 were positive, but CD20 (L26), CD4, CD8, and betaF1 were negative. Epstein-Barr virus (EBV) mRNA was detected in the nuclei of neoplastic cells by in situ hybridization. Subcutaneous panniculitis-like T cell lymphoma is reported to be an EBV-negative, clonal T cell neoplasm. Although this case showed clinical and morphological features that resembled SPTCL, perinuclear polyclonal CD3 staining and membranous CD56 reactivity seen in neoplastic cells were suggestive of NK cells. Furthermore, the neoplastic cells were positive for EBV. This case is considered to be a NK/T cell lymphoma of the subcutis resembling SPTCL. It is believed that it is important to recognize such a tumor because patients may undergo a fulminant clinical course, despite the tumor being localized in the subcutaneous adipose tissue.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/21. Disseminated and recurrent sarcoid-like granulomatous panniculitis due to bovine collagen injection.Three to five percent of patients treated with injectable collagen implants have adverse local reactions. Systemic signs or symptoms are infrequent. We describe the case of a 53-year-old woman who developed local and general complaints 2 months after receiving two collagen injections in both nasolabial folds. She presented asthenia, malaise, polyarthralgia and inflammatory nodular panniculitis in the places of injection as well as on the forearms and lower extremities. skin testing was compatible with hypersensitivity to collagen. This case raises the question as to whether the injection of animal-derived collagen induces manifestations similar to those observed in connective autoimmune diseases or human adjuvant disease.- - - - - - - - - - ranking = 148.85483319629keywords = connective (Clic here for more details about this article) |
3/21. panniculitis: a cutaneous manifestation of dermatomyositis.Specific and nonspecific panniculitis sometimes occurs during the course of connective tissue diseases. However, the association of panniculitis and dermatomyositis (DM) has only rarely been described. Previous reports have suggested that panniculitis may be an inherent part of DM but, because the cases reported are few, it is difficult to know the significance of this unusual association. We describe 2 patients with DM in whom panniculitis developed during the course of the disease, and discuss its clinical and diagnostic significance.- - - - - - - - - - ranking = 148.85483319629keywords = connective (Clic here for more details about this article) |
4/21. panniculitis in a patient on methotrexate for mixed connective tissue disease.Accelerated nodulosis during methotrexate therapy for rheumatoid arthritis has been well described. There have been recent reports of nodulosis in patients on methotrexate for other inflammatory conditions. panniculitis is a newly discovered pathological entity in this setting. We describe a case of panniculitis in a woman receiving methotrexate for mixed connective tissue disease.- - - - - - - - - - ranking = 744.27416598147keywords = connective (Clic here for more details about this article) |
5/21. Subcutaneous panniculitic T-cell lymphoma in a cardiac allograft recipient.BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is the third leading cause of death in heart transplant patients beyond the immediate peri-operative period (Ouseph R, Denny DM, Erbeck KM. J Am Soc Echocardiogr 1998; 11: 758; Armitage JM, Kormos RL, Stuart RS, et al. J heart lung Transplant 1991; 10: 877; Swinnen LJ, Mullen M, Carr TJ, et al. blood 1995; 86: 3333; Ying AJ, Myerowitz D, Marsh WL. Ann Thorac Surg 1997; 64: 1822). The majority of PTLD cases are of B-cell origin whereas T-cell neoplasms have been reported as rare, aggressive, and late complications of solid-organ transplantation (Fatio R, Sutsch G, Mayer K, et al. Transplant Proc 1998; 30: 1118). CASE REPORT: A 50-year-old cardiac allograft heart transplant patient presented with subcutaneous nodules involving his trunk and extremities. RESULTS: light microscopy revealed features characteristic of subcutaneous panniculitic-like T-cell lymphoma. Immunohistochemical analysis showed expression for CD45RO, TIA-1, and focal CD3 positivity by tumor cells. flow cytometry performed on a subsequent subcutaneous nodule demonstrated an abnormal T-cell population with expression of CD3, CD8, CD56, and T-cell receptor alpha-beta, and no expression of CD4. T-cell gene rearrangement studies revealed a clonal population of cells with a bi-allelic gene rearrangement. CONCLUSION: We report a case of an unusual subtype of PTLD in a cardiac allograft recipient.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
6/21. Postirradiation morphea and subcutaneous polyarteritis nodosa: case report and literature review.OBJECTIVE: To describe a case of postirradiation morphea and subcutaneous polyarteritis nodosa occurring simultaneously in a patient and to review the literature on postirradiation autoimmune phenomenon and the potential pathogenesis of such changes. methods: A 75-year-old woman with breast cancer treated with chemotherapy and radiation who developed postirradiation morphea and subcutaneous polyarteritis nodosa, both inside and outside of the field of radiation, is described. literature searches were performed on postirradiation morphea and other radiation-related inflammatory cutaneous conditions and the potential pathogenic mechanisms involved. RESULTS: Twenty-five cases of postirradiation morphea and 8 cases of postirradiation panniculitis were reported in the literature. Only 3 cases of morphea with distant vasculitis occurring in the same patient have been reported and each of these patients had features suggestive of an underlying connective tissue disease. This is the first case of morphea and subcutaneous polyarteritis nodosa occurring in the same location both inside and outside the field of radiation. CONCLUSIONS: Postirradiation morphea is an uncommon condition but is being increasingly recognized. Related phenomena following radiation include postirradiation panniculitis and now postirradiation subcutaneous polyarteritis nodosa. radiation may be responsible for inducing some of the pathogenic changes seen in scleroderma and other autoimmune diseases. Rheumatologists should be aware of these potential complications of radiation treatment.- - - - - - - - - - ranking = 148.85483319629keywords = connective (Clic here for more details about this article) |
7/21. Calcifying panniculitis following subcutaneous injections of nadroparin-calcium in a patient with osteomalacia.Calcifying panniculitis is a rare form of calcinosis cutis belonging to the spectrum of calciphylaxis that has almost invariably been described in patients with severe renal disturbances. We report a patient with osteomalacia without chronic renal failure, who developed calcifying panniculitis following subcutaneous administration of nadroparin-calcium. light microscopy studies of biopsy specimens revealed multiple foci of microcalcification within the adipose lobules, in the interadipocyte spaces, in connective tissue septa and in the media of small arteries in the subcutis. The patient had an elevated level of intact parathyroid hormone, whereas the calcium-phosphorus product was normal. The lesions slowly resolved upon discontinuation of nadroparin. We conclude that calcifying panniculitis is a rare complication associated with the subcutaneous administration of nadroparin-calcium that may rarely also occur in the absence of renal disturbances. Low molecular weight calcium-containing heparins should probably be used with caution in the presence of hyperparathyroidism.- - - - - - - - - - ranking = 148.85483319629keywords = connective (Clic here for more details about this article) |
8/21. Connective tissue panniculitis in a child with vitiligo and Hashimoto's thyroiditis.SUMMARY A 9-year-old girl presented with a 6-month history of inflamed tender nodules in the pretibial area. These eventually healed leaving depressed areas of atrophy and loss of subcutaneous tissue. histology showed a predominantly lymphocytic lobular panniculitis, consistent with connective tissue panniculitis. Investigations revealed an elevated thyroid stimulating hormone, elevated thyroid antiperoxidase antibody and a weakly positive antinuclear antibody (titre 1 in 40). She was commenced on hydroxychloroquine 300 mg daily, which resulted in resolution of the panniculitis. She developed focal vitiligo on the thighs. This gradually improved with 0.1% mometasone furoate ointment. The hydroxychloroquine dose was tapered to 200 mg daily after 12 months, then to 100 mg daily after 18 months therapy. Her thyroid autoantibody levels continued to rise and the hydroxychloroquine was increased again to 300 mg daily. She became borderline hypothyroid. Hashimoto's thyroiditis was diagnosed. thyroxine was instituted with a resultant improvement in her thyroid blood tests. The lipoatrophy has not developed further during 2-year follow up.- - - - - - - - - - ranking = 148.85483319629keywords = connective (Clic here for more details about this article) |
9/21. Annular lipoatrophy of the ankles.Lipoatrophic panniculitis likely represents a group of disorders characterized by an inflammatory panniculitis followed by lipoatrophy. It occurs locally in a variety of settings and has been reported in the literature under various terms, including annular atrophic connective tissue panniculitis of the ankles, annular and semicircular lipoatrophy, abdominal lipoatrophy, and connective tissue panniculitis. Herein, a case of annular lipoatrophy of the ankles is described in a 6-year-old girl with autoimmune thyroid disease. Histologically, a mixed lobular panniculitis with lipophages was present. This pattern resembles that seen in lipoatrophic panniculitis. After a single, acute episode of an inflammatory process with subsequent lipoatrophy, her skin lesions have stabilized for 2 years requiring no treatment.- - - - - - - - - - ranking = 297.70966639259keywords = connective (Clic here for more details about this article) |
10/21. panniculitis: an unusual cutaneous manifestation of rheumatoid arthritis.Specific and nonspecific panniculitis may occur during the course of connective tissue diseases. However, association of panniculitis and rheumatoid arthritis has only rarely been described, and with so few reports, it is difficult to know the significance of this unusual association. We describe 2 patients with rheumatoid arthritis and features of Sjogren syndrome in whom panniculitis developed during the course of the disease. Histologic confirmation of septal panniculitis was established in one case and the panniculitis in this case improved as the arthritis resolved.- - - - - - - - - - ranking = 148.85483319629keywords = connective (Clic here for more details about this article) |
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