Interactive Case Study - March 2023

A 75-year-old male with violaceous papules and nodules on the torso and face.

Brittainy Hereford, MD; Veronica Merelo Alcocer, MD; Alexandra Flamm, MD; Matthew Helm, MD

A 75-year-old man presents with violaceous papules and nodules on the torso and face. The lesions are painless and have been continuously growing since onset four months ago.

Click this image to view the virtual slide.

Figure 1: H&E 4x

Figure 2: H&E 20x

Figure 3: CD4 20x

Figure 4: CD56 20x

Of note, immunohistochemical staining of the process was negative for CD3, CD8, CD20, and myeloperoxidase (MPO). Additional staining at an outside institution were positive for CD123 and TCF4.

Which of the following is the best diagnosis?

A.	Blastic Plasmacytoid Dendritic Cell Neoplasm

B.	CD56+ Acute Myeloid Leukemia

C.	Cutaneous T-Cell Lymphoma

D.	Extranodal Natural Killer/T-Cell Lymphoma

E.	Subcutaneous Panniculitis-Like T-Cell Lymphoma