Subcutaneous panniculitis-like T-cell lymphoma

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare slow-growing (indolent) type of non-Hodgkin lymphoma (NHL). It is often mistaken for panniculitis, which is an inflammation of the fatty tissue under the skin.

SPTCL occurs most often in people who are 40 to 60 years old. More women develop SPTCL than men. Some people who develop SPTCL have an autoimmune disease (a disorder that causes the immune system to attack the body’s own tissue).

Symptoms

SPTCL causes lumps to form under the skin on the legs, chest, belly or back. These can become inflamed open sores. SPTCL usually only affects the skin. It doesn’t usually affect other parts of the body, such as the lymph nodes or bone marrow.

Some people with SPTCL develop a serious condition called hemophagocytic syndrome. It causes:

  • fever
  • larger than normal liver and spleen
  • low numbers of red blood cells, white blood cells and platelets (called pancytopenia)

Treatments

There is no standard treatment for SPTCL. You may be offered chemotherapy, other drugs or radiation therapy.

Chemotherapy

Combinations of chemotherapy drugs are usually given to treat SPTCL. A common combination used is CHOP:

  • cyclophosphamide (Cytoxan, Procytox)
  • doxorubicin (Adriamycin)
  • vincristine (Oncovin)
  • prednisone

Other drugs that may also be used to treat SPTCL are:

  • corticosteroids such as prednisone
  • drugs that suppress the immune system such as methotrexate or cyclosporine (Neoral)

Radiation therapy

External beam radiation therapy may be given to treat lumps under the skin.

Expert review and references

  • American Society of Clinical Oncology. Lymphoma Non-Hodgkin Overview. 2014: http://www.cancer.net/cancer-types/lymphoma-non-hodgkin/view-all.
  • Freedman AS, Jacobson CA, Mauch P, Aster JC . Non-Hodgkin lymphoma. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 103:1552-1583.
  • Lazaryan A, Sweetenham J . Rare T cell lymphomas. Raghavan D, Blanke CD, Honson DH, et al (eds.). Textbook of Uncommon Cancer. 4th ed. Wiley Blackwell; 2012: 48: 659 - 666.