A 58-year-old man presented with a one-month history of multiple tender, erythematous subcutaneous nodules, involving bilateral lower extremities. Before onset of the nodules, the patient had fever, chills, malaise and myalgias for a few days. Despite treatment with antibiotics and local steroid preparation, there was no improvement of clinical symptoms. His peripheral blood showed no cytopenia. Physical examination revealed no hepatosplenomegaly and lymphadenopathy. A skin biopsy was performed (Figs. 60.1, 60.2, 60.3, and 60.4).


Anaplastic Large Cell Lymphoma Hemophagocytic Syndrome Bilateral Lower Extremity Multiple Tender Gene Rearrangement Analysis 
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