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Subcutaneous panniculitis-like T-cell lymphoma misdiagnosed as erythema nodosum induced by influenza and typhoid fever
( Gyeong Hun Park ) , ( Youin Bae ) , ( Young Hee Choi ) , ( Jung Jin Cho )
프로그램북 68권 1호 432-432(1pages)
UCI I410-ECN-0102-2017-510-000108874
이 자료는 4페이지 이하의 자료입니다.

Patients with subcutaneous panniculitis-like T-cell lymphoma (SPTL) present with typical nodular lesions or plaques which have usually persisted for at least several months to years. Furthermore, systemic symptoms including fever are often accompanied by SPTL. Thus, at early stage, SPTL may be confused with other benign panniculitis such as erythema nodosum associated with infectious conditions. A 67-year-old man presented with a four-day history of mild fever, and multiple erythematous round plaques or swelling on the both shins and left cheek. Based on the positive results for influenza A antigen, he was diagnosed as influenza infection with erythema nodosum. However, despite talniflumate and oseltamivir therapy for five days, the fever persisted and new lesions were developed. In addition, further work-ups disclosed an increased Widal O antigen titer (1:1280), and thus he was diagnosed as typhoid fever with erythema nodosum. However, the fever and cutaneous lesions were not improved by ciprofloxacin and naproxen. Finally, a skin biopsy revealed a dense atypical lymphocytic infiltration involving the subcutaneous fat layer in a lobular and septal pattern. The cells were positive for CD3, CD8, and granzyme B, and negative for CD4, CD20, CD56, CD30, and Epstein-Barr virus. Based on the skin biopsy findings, he was diagnosed as SPTL, and the fever and skin lesions were improved by administration of high dose prednisolone.

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