case_images: PMC11095181_01
case_images: Patient photographs showed lesions presenting as erythematous plaques and nodules (arrows) on the skin of the right lower leg (A) and abdomen (B).
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case_images: C to 39 C, alongside the emergence of dark brown pigmented patches on the chest, abdomen, waist, lower leg, which were tender but not indurated (Figure 1). Concurrent ankle pain exacerbated by movement was also reported.
case_images: Microscopic images of hematoxylin-eosin staining sections: (A) Normal appearance of the epidermal and dermal layers (double-headed arrow, 200x magnification). (B) Subcutaneous fat layer infiltrated with numerous atypical lymphocytes (arrows), clustering around the periphery of fat cells (asterisks), with hyperchromatic nuclei, irregular nuclear membranes, and ranging in size from small to medium (400x magnification).
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case_images: Histological examination revealed a normal epidermis and dermis, but with extensive infiltration of atypical lymphocytes in the subcutaneous fat layer, clustering around adipocytes, displaying hyperchromatic and irregularly bordered nuclei of small to medium size (Figure 2).
case_images: Immunohistochemical staining images showed that tumor cells positive for CD3 (A, 400x magnification) and CD8 (B, 400x magnification), with stained brown-yellow; negative for CD4 (C, 400x magnification) and CD56 (D, 400x magnification).
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case_images: Immunohistochemical staining showed positivity for CD3, a high proliferation index with Ki-67 (+, 50%), and positivity for CD8, with negativity for CD20, CD4, and CD56 (Figure 3).