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Figure 1: Multiple confluent erythematous nodules and plaques in the lower legs and lower back at presentation (upper panel). Resolution of skin lesions with residual pigmentation following 2 cycles of SMILE chemotherapy (lower panel).
Figure 2: Skin biopsy histopathology and immunochemistry a) Diffuse dermal and subcutaneous infiltrate of lymphoma cells (H and E, x20). b) Higher magnification demonstrating medium to large in size pleomorphic lymphoma cells with hyperchromatic nuclei and irregular nuclear outlines (H and E x400) c) Strong cytoplasmic CD3 (epsilon) expression of lymphoma cells in periadnexal and perivascular distribution. d) Epstein-Barr Virus Encoded RNA (EBER) expression of lymphoma cells, including in perivascular (red arrow) and perineurial (blue arrow) distribution. e) Cytoplasmic expression of the cytotoxic protein Granzyme B by the lymphoma cell (H and E x200). f) Moderate to strong CD56 expression by the lymphoma cells (H and E x400).