루푸스 지방층염의 병력이 있는 환자에서 발생한 비전형적 림프구성 소엽 지방층염 = Atypical Lymphocytic Lobular Panniculitis in Patient with a History of Lupus Panniculitis

다국어 초록 (Multilingual Abstract)

A 46-year-old female presented with systemic symptoms and widespread, tender, skin-colored to erythematous indurated patches and subcutaneous nodules. She had a history of biopsy-proven lupus panniculitis on both shoulders 28 years prior. A recent incisional biopsy revealed histopathologic findings distinct from those of her previous diagnosis, including lymphocytes with mild atypia, adipocyte rimming, adipocyte membrane disruption, and lymphocyte internalization. Focal Ki-67 hotspots with a mild predominance of CD8＋ T cells were also observed.
Notably, prominent atypia, vascular thrombosis, and erythrophagocytosis, which are hallmarks of subcutaneous panniculitis-like T-cell lymphoma, were absent. The patient was diagnosed with atypical lymphocytic lobular panniculitis and treated with oral prednisolone and hydroxychloroquine. Her skin lesions resolved completely, and she remains under clinical follow-up with no signs of recurrence.