Not Only B but Also T: Lymphomas Localized to the Leg

Cutaneous T-cell lymphomas (CTCLs) affect the leg preferentially but not exclusively; pagetoid reticulosis and subcutaneous panniculitis-like T-cell lymphoma are T-cell lymphomas that most frequently affect the lower extremities. Now, the authors of a retrospective, clinicopathologic study of three elderly patients describe a distinct CTCL variant found exclusively on the leg below the knee.

An 82-year-old man with nodular lesions on the right lower leg developed an ulcer with an infiltrative border. Biopsy examination revealed a predominantly dermal infiltrate of large atypical lymphocytes (CD2⁺, CD3⁺, and CD4⁺, with loss of CD5 and CD7). T-cell gene rearrangement was identified. Topical carmustine therapy was unsuccessful, as were experime…