A Rare and Fatal Case of Cutaneous T-Cell Lymphoma (CTCL)

Lia Sasmithae, Indra Perdana


Introduction: Cutaneous T-Cell Lymphoma (CTCL) is a form of Non-Hodgkin Lymphoma involving T-cell neoplasms mainly concentrated in the skin. Primary Cutaneous Peripheral T-Cell Lymphoma is Not Otherwise Specified (PTL-NOS) is the rarest case of CTCL disease.

Case Presentation: A female, 35 years old, complained of a lump on her face. In the last 3 months, the lump felt soft, contained a liquid that, when it ruptures, secretes Blood, and the crusty scar will blacken and easily bleed with pain. Physical examination of pale conjunctiva on the face, neck, chest, abdomen, back, and legs obtained nodules with a chewy consistency with erythema appearance in varying size. Some nodules that appear were covered in blackish crustae. The right lung has a decrease in the sound of breath, accompanied by swelling in both limbs. The conclusion of bilateral femur skin biopsy impresses cutaneous T lymphoma cells. Within three months, cancer developed into lesions spread almost throughout the body, and due to the rapid and progressive nature of cancer, its diagnosis developed into PTL-NOS.

Conclusions: Patients with PTL-NOS may come with solitary nodules such as red tumors in any area of the body. However, most often, patients come with symptoms of multifocal or diffuse scattered nodules. In enforcing the diagnosis, it takes a high level of suspicion, and multiple rebiopsies are necessary to enforce the diagnosis of CTCL.


cutaneous lymphoma, CTCL, PTL-NOS


Sigurdsson V, Toonstra J, Hezemans-Boer M, Van Vloten WA. Erythroderma: A clinical and follow-up study of 102 patients, with special emphasis on survival. J Am Acad Dermatol. 1996;35(1):53–7.

Batrani M, Bhawan J. Pitfalls in the diagnosis of cutaneous lymphoma. Am J Dermatopathol. 2014;36(1):90–100.

Gupta A, Sundram U. Cutaneous lymphoma. J Clin Pathol. 2018;71(2):185.

Vermeer MH, Willemze R. Limited effect of chemotherapy in cutaneous lymphoma. Blood. 2015;125(1):4–5.

Shetty SK, Hegde U, Jagadish L, Shetty C. Pseudolymphoma versus lymphoma: An important diagnostic decision. J Oral Maxillofac Pathol. 2016;20(2):328.

Shtilionova S, Drumeva P, Balabanova M, Krasnaliev I. What is pseudolymphoma and its nature. J IMAB. 2010;16(3):106–106.

Shashikumar B, Harish M, Katwe K, Kavya M. Cutaneous pseudolymphoma: An enigma. Clin Dermatology Rev. 2017;1(1):22.

Beyer M SW. Cutaneous lymphoma. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS LD, ed. Fitzpatrick's Dermatology In General Medicine. 8th ed. New York: Mc Graw Hill Companies; 2012:1745–1766.

Willemze R. Cutaneous T-cell lymphoma. In: Bolognia Jl, Jorizzo JL, Rapini RP, Callen JP, Horn TD, Mancini AJ et al, ed. Dermatology. 2nd ed. Mosby: Elsevier Inc.; 2008:1867–1886.

Aderhold K, Carpenter L, Brown K, Donato A. Primary cutaneous peripheral t-cell lymphoma not otherwise specified: A rapidly progressive variant of cutaneous t-cell lymphoma. Case Rep Oncol Med. 2015;2015(Figure 1):1–3.

Willemze R, Meijer CJLM. Classification of cutaneous T-cell lymphoma: From Alibert to WHO-EORTC. J Cutan Pathol. 2006;33(SUPPL. 1):18–26.

Rezk SA, Zhao X, Weiss LM. Epstein-Barr virus (EBV)–associated lymphoid proliferations, a 2018 update. Hum Pathol. 2018;79:18–41.

James WD. Cutaneous lymphoid hyperplasia, cutaneous T-cell lymphoma, other malignant lymphomas, and allied disease. In: James WD, Berger TG ED, ed. Andrew’s disease of the skin clinical dermatology. 10thed. Philadelphia: Elsevier Saunder; 2006:725–48.

Willemze R, Jansen PM, Cerroni L, et al. Subcutaneous panniculitis-like T-cell lymphoma: Definition, classification, and prognostic factors: An EORTC Cutaneous Lymphoma Group Study of 83 cases. Blood. 2008;111(2):838–45.

Gallamini A, Stelitano C, Calvi R, et al. Peripheral T-cell lymphoma unspecified (PTCL-U): A new prognostic model from a retrospective multicentric clinical study. Blood. 2004;103(7):2474–9.

Rezania D, Sokol L, Cualing HD. Classification and treatment of rare and aggressive types of peripheral T-cell/natural killer-cell lymphomas of the skin. Cancer Control. 2007;14(2):112–23.

Choi MY, Lechowicz MJ. Management of the cutaneous peripheral T-cell lymphomas: when subtypes matter. Cancer J. 2012;18(5):439–44.

Rodriguez-Abreu D, Filho VB, Zucca E. Peripheral T-cell lymphomas, unspecified (or not otherwise specified): A review. Hematol Oncol. 2008;26(1):8–20.

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DOI: 10.33371/ijoc.v15i3.803

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