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30♀️ posterior chest wall mass. Good example of this entity. IHC in next tweet. #dermpath #pathology 
#IHCpath: CD4 is also a myelomonocytic marker, so weak staining is expected in macrophages. Only strong CD4 positivity is counted as genuine for T-cells.
Full #IHCpath:
➕ Pan T-cell markers (CD3, CD2, CD5, CD7), CD8, perforin, TIA, beta-F1 (TCR beta)
➖ CD4 CD30 CD56
➕ Pan T-cell markers (CD3, CD2, CD5, CD7), CD8, perforin, TIA, beta-F1 (TCR beta)
➖ CD4 CD30 CD56
Thank you @FJMazorra, @Salib_MD & @BhuvaneshwariA8
Diagnosis: subcutaneous panniculitis-like T-cell lymphoma, a rare lymphoma with a slight ♀️ preponderance. The WHO blue book suggests it occurs across a wide age range, but median age is 35 and 20% occur <20 years. #hemepath
Diagnosis: subcutaneous panniculitis-like T-cell lymphoma, a rare lymphoma with a slight ♀️ preponderance. The WHO blue book suggests it occurs across a wide age range, but median age is 35 and 20% occur <20 years. #hemepath
The closest differential diagnosis is lupus panniculitis and distinction may not always be straightforward as there may be an association with autoimmune disease. Clinically, it presents as subcutaneous nodules. About half of cases show systemic features.
Morphologically:
▶️ Rimming of adipocytes by CD8+ T-cells
▶️ Karyorrhectic debris
▶️ Admixed reactive histiocytes
▶️ Plasma cells and plasmacytic dendritic cells less prominent than SLE
▶️ Epidermis/dermis uninvolved
#IHCpath is that of an alpha/beta CD8+ cytotoxic cell.
▶️ Rimming of adipocytes by CD8+ T-cells
▶️ Karyorrhectic debris
▶️ Admixed reactive histiocytes
▶️ Plasma cells and plasmacytic dendritic cells less prominent than SLE
▶️ Epidermis/dermis uninvolved
#IHCpath is that of an alpha/beta CD8+ cytotoxic cell.
