Primary Cutaneous T-cell Lymphoma – A Diagnostic Dilemma

Cutaneous lymphomas are a heterogenous group of neoplasm confined to skin at the time of diagnosis. These are extranodal non-Hodgkin lymphomas (NHLs). Here, we present a case of 58 years male who presented to the dermatology outpatient department with complaints of multiple painless nodules with petechial rashes over both arms, hand, trunk, body and legs, which were not associated with any other symptoms. A biopsy from one of the lesions was sent with clinical suspicion of sarcoidosis, pseudolymphoma and metastasis. On microscopic examination, diffuse infiltration of atypical cells in the dermis was seen with membranous positivity for CD45, CD3 and CD5. Based on the history, clinical examination and histopathological evaluation, a final diagnosis of T-cell NHL was given. Our patient was started on 6 cycles of 10 mg/m 2 of doxorubicin and 50 mg/m 2 of methotrexate per week. He is asymptomatic on 3 months of follow-up, with no new lesions and bearable side effects of chemotherapeutic agents.