About 15–20% of patients with concomitant hemophagocytic syndrome may have elevated liver enzymes ( 4) but early presentation with severe jaundice is relatively rare. This disease is a rare type of lymphoma with specific clinical manifestations and histological changes. SPTCL was first reported as a new kind of T-cell lymphoma in 1991 ( 1) and was officially named by the International Collaborative Group of Lymphoma Research (REAL Classification) in 1994 ( 2) and incorporated into the peripheral T-cell and natural killer cell tumors in 2001 ( 3). Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare cytotoxic T-cell lymphoma, accounting for less than 1% of all non-Hodgkin's lymphomas and 1% of primary cutaneous T-cell lymphomas, mainly involving subcutaneous adipose tissue, with some patients having bone marrow invasion and concomitant phagocytic syndrome, the latter with rapid disease progression and poor prognosis ( 1). Early skin pathology biopsy may help in the early diagnosis of SPTCL.What is the implication, and what should change now? The possibility of SPTCL needs to be considered early in the screening of patients with clinical liver failure for its etiology.Some of the previous reports of SPTCL may be combined with liver function abnormalities, however, this is the first case of SPTCL with fever and liver failure as the main manifestations.SPTCL is a rare cause of liver failure.For this condition, early detection and early diagnosis may improve the prognosis of patients. A review of the literature revealed that this is the first case report in the literature of SPTCL leading to severe liver failure.Ĭonclusions: For patients presenting with fever and liver injury, primary liver disease cannot simply be assumed, as this presentation may be a manifestation of some extra-hepatic diseases, including SPTCL. With this case report, we hope to improve clinicians' understanding of liver injury caused by SPTCL. And then, we performed a skin biopsy and the final pathological diagnosis was SPTCL, but the patient died 1 month after diagnosis due to poor treatment outcome because the disease progressed too rapidly. We continued to refine the positron emission tomography-computed tomography (PET-CT) examination, which revealed multiple flocculent and nodular hyperdense shadows with increased metabolism in the subcutaneous fat interstices. Laboratory tests revealed hepatic impairment, and common causes of liver failure (viral infection, fatty liver, immune liver damage, etc.) were excluded. Examination revealed multiple small subcutaneous nodules on the skin of the chest and tibial surface and an enlarged liver and spleen. Here, we present a case of an adult diagnosed with fever and liver failure as the main manifestation, which was eventually confirmed as SPTCL by skin biopsy, but the patient eventually died due to disease progression.Ĭase Description: This study retrospectively reports a rare case of SPTCL in a 34-year-old female patient who was admitted with scleral jaundice for 1 month and fever for 20 days. However, no cases of progression to hepatic failure have been reported. Policy of Dealing with Allegations of Research Misconductīackground: Subcutaneous lipofuscinosis-like T-cell lymphoma (SPTCL) is a rare cutaneous lymphoma that often presents as recurrent subcutaneous nodules and may progress to hemophagocytic syndrome with fever and hepatic impairment in some patients.Policy of Screening for Plagiarism Process.
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