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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1290 - 03 June Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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This is a 13-year-old female with subcutaneous nodules with fever, anemia, leukopenia, and increased LFTs.

Case posted by Dr Hafeez Diwan


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Guest Romualdo

Posted

Subcutaneous panniculitis-like T-cell lymphoma with interface changes, dermal mucin and associated hemophagocytic symdrome (hemophagocytic lymphohistiocytosis).

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IgorSC

Posted

Some possible diagnosis here (or a combination of them). My first diagnosis is SPLTCL associated with hemophagocytic syndrome, as stated by Romualdo. As the patient has hemophagocytic syndrome and dermal lymphocites, we have to evaluate the possibility of gama/delta T-Cell Lymphoma. Maybe the most likely is an association of SPLTCL with Lupus. They can coexist and even may be correlated, as some lupus patients evolve to SPLTCL, and some patients with SPLTCL presents with direct immunofluorescence and laboratory findings consistent with Lupus. I think immunohistochemistry and CPC are essential here.

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Dr. Mona Abdel-Halim

Posted

Subcutaneous panniculitis like TCL associated with hemophagocytic syndrome

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Dr. Mona Abdel-Halim

Posted

SPLTCL associated with hemophagocytic syndrome

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Eman El-Nabarawy

Posted

SPLTCL with hemophagcytic syndrome.

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Arti Bakshi

Posted

SPLTCL is the favoured diagnosis here.
There is overlap between lupus profundus and SPLTCL and the presence of interface change with dermal mucin is interesting in this case. Agree with Igor that the case needs immunos and cpc.

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Dr. Hafeez Diwan

Posted

I called this atypical lymphocytic lobular panniculitis but I think that SPTCL might be the better diagnosis for this.

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