Skin inflammatory (nontumor)
Cytophagic histiocytic panniculitis

Author: Mowafak Hamodat, M.D., M.Sc. (see Authors page)

Revised: 22 October 2018, last major update July 2011

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Cytophagic histiocytic panniculitis

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Cite this page: Hamodat, M. Cytophagic histiocytic panniculitis. website. Accessed March 20th, 2019.
Definition / general
  • Panniculitis associated with hemophagocytic syndrome
  • Associated with CMV, EBV, HIV, bacteria, fungi and parasites
  • Occurs post-bone marrow transplant, with SLE, as adverse reaction to interferon alpha therapy
  • Associated with T cell lymphoma
  • Presents with spiking fever, erythematous subcutaneous skin nodules, anemia, leukopenia
  • May be fatal with multisystemic involvement
Clinical features
  • Erythematosus to violaceous or hemorrhagic nodules, often in lower limbs and trunk
  • Ulceration with localized or generalized edema
Microscopic (histologic) description
  • Lobular or partially septal distribution of florid lobular panniculitis, with large histiocytes containing eosinophilic cytoplasm; also neutrophils and lymphocytes
  • Red cell extravasation typically present with frank hemorrhage
  • Erythrophagocytosis, phagocytosis of lymphocytes or nuclear debris
  • Enlarged histiocytes may be described as "bean bag cell"
  • Usually no giant cells / granulomas
Microscopic (histologic) images

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11 year old girl with perforin gene mutation

Differential diagnosis
  • Angiocentric lymphoma
  • Cutaneous Rosai Dorfman disease
  • Subcutaneous T cell panniculitis lymphoma
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