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| Fig. 19.10 B-cell lymphoma mimicking panniculitis. (Courtesy of Kenneth E. Greer, MD.) |
Malignant infiltrates can sometimes produce subcutaneous nodules that mimic other forms of panniculitis. Malignancies that are capable of producing panniculitis-like lesions include poorly differentiated carcinomas, lymphomas (Fig. 19-10), multiple myeloma, and leukemias. Microscopic clues to the recognition of malignant infiltrates include a monotonous cell population and/or cytologic atypia, “lining up” of atypical cells between collagen bundles, and minimal alteration of connective tissue in the presence of dense cellular infiltration. Also, forms of more traditional inflammatory panniculitis can accompany malignancy, including erythema nodosum, migratory thrombophlebitis, and pancreatic fat necrosis. Therefore, diagnosis again is heavily dependent on biopsy.
Cassis TB, Fearneyhough PK, Callen JP: Subcutaneous panniculitis-like T-cell lymphoma with vacuolar interface dermatitis resembling lupus erythematosus panniculitis, J Am Acad Dermatol 50:465–469, 2004.
