Title : Disentangling the diagnostic knot: Uncovering subcutaneous panniculitis-like T Cell lymphoma in a presumed case of actinomycosis- A case report
Abstract:
Background: Subcutaneous panniculitis-like T cell lymphoma (SPTCL) is a rare skin lymphoma characterized by infiltration of the subcutaneous tissues with cytotoxic T cells without associated lymph node involvement. STPCL is diagnostically challenging, particularly in early stages, due to symptoms mimicking common skin conditions like eczema, dermatitis, and cellulitis. The treatment is not standardized and may include systemic steroids, multidrug chemotherapy or cyclosporine.
The case: A 43-years old Indian woman presented a fever and right orbital swelling with discharge for 5 months. She was diagnosed with Actinomycosis following initial examination and investigations and was treated with targeted antibiotics for months but to no avail. A second opinion was immediately requested regarding the primary histopathological results and following reexamination and investigative analysis the patient was re-diagnosed as an unusual presentation of SPTCL.
Conclusion: STPCL requires meticulous clinical and pathological investigation. This case exemplifies on an unusual presentation of SPTCL and how initial diagnostic assumptions without re-analysis especially in cases of targeted treatment failure can lead to prolonged inappropriate treatment, potentially compromising patient outcomes.
