Introduction: The coexistence of renal cell carcinoma and classic Hodgkin lymphoma is exceedingly rare, with only two documented cases. Here, we present the third case diagnosed in our institution.Case presentation: A 46‐year‐old man presented with right flank pain, fever, mild pancytopenia, and renal mass on computed tomography scan, suggesting renal malignancy. Despite intravenous antibiotics and extensive workup for recurrent fever, his condition did not improve. A bone marrow biopsy revealed rare large EBV‐positive B cells. Surprisingly, imaging only showed minimal intraabdominal lymphadenopathy in the perinephric region. Subsequent surgery confirmed clear cell renal cell carcinoma in the kidney and scattered large, atypical cells consistent with classic Hodgkin lymphoma in the suprahilar lymph node.Conclusion: This case presents a rare case of classic Hodgkin lymphoma occurring in the perirenal region. When clinicians encounter unexplained symptoms in patients with primary tumors, additional biopsies should be considered for possible secondary malignancy.

Salivary duct carcinoma is a rare, aggressive salivary gland malignancy that morphologically and immunophenotypically resembles breast ductal carcinoma. The rhabdoid variant is characterized by discohesive tumor cells with rhabdoid cytomorphology, frequent loss of E-cadherin expression, and morphologic overlap with pleomorphic invasive lobular carcinoma of the breast. We report a 74-year-old man who presented with an enlarging right buccal mass and trismus. Positron emission tomography–computed tomography demonstrated right cervical lymphadenopathy with no evidence of breast or lung primary. Resection revealed a discohesive, infiltrative tumor composed of pleomorphic rhabdoid cells, with scattered cells containing intracytoplasmic mucin imparting a signet-ring morphology, and prominent targetoid perineural invasion. Immunohistochemically, the tumor showed diffuse positivity for keratin 7, gross cystic disease fluid protein 15 (GCDFP15/PIP), androgen receptor, weak GATA3 expression, loss of E-cadherin, and cytoplasmic p120-catenin (CTNND1) staining, a profile closely resembling that of invasive lobular carcinoma. Extensive nodal metastases were identified. Despite multimodal therapy, the disease recurred. This report highlights the importance of recognizing salivary duct carcinoma with rhabdoid features to avoid misdiagnosis and guide appropriate management.

Cutaneous extramedullary hematopoiesis (CEH) is a rare manifestation of extramedullary hematopoiesis (EMH), a process typically associated with fetal development or myeloproliferative neoplasms. EMH most commonly involves the spleen, liver, and lymph nodes, with CEH being exceedingly rare in chronic myeloid leukemia (CML). Here, we present a 34‐year‐old Hispanic male with multiple bilateral lower extremity lesions, right buttock and leg pain, fatigue, and splenomegaly, who was found to have chronic‐phase CML. Punch biopsy of one of the skin lesions demonstrated dermal infiltration by maturing hematopoietic elements, including granulocytes, megakaryocytes, and erythroid precursors, with fluorescence in situ hybridization (FISH) testing confirming a neoplastic extramedullary hematopoietic infiltrate with the presence of BCR::ABL1 fusion. Initial treatment included hydroxyurea and dasatinib; however, after chronic‐phase CML was confirmed, therapy was transitioned to imatinib, resulting in resolution of B symptoms, normalization of WBC counts, and reduced leg swelling. This case underscores the importance of distinguishing CEH from aggressive disease states, such as blast‐phase CML or myeloid sarcoma, through comprehensive histopathological and immunohistochemical analysis.

Primary cutaneous gamma‐delta T‐cell lymphoma (PCGD‐TCL) is a rare cytotoxic lymphoma with key oncogenic drivers in the JAK/STAT pathway. Also primarily involving the subcutaneous adipose tissue, subcutaneous panniculitis‐like T‐cell lymphoma (SPTCL) is more frequently encountered in scenarios of autoimmune disorders. SPTCL shares clinicopathologic overlap with lupus panniculitis. However, the link between autoimmunity and PCGD‐TCL is much less established, particularly in the setting of long‐standing, immunosuppressed dermatomyositis (DM). We report two cases of PCGD‐TCL arising in women with chronic anti‐TIF1‐γ DM following years of immunosuppressive therapy. Case 1 is a 47‐year‐old woman with a 19‐year history of DM on azathioprine/prednisone who developed rapidly progressive, painful subcutaneous nodules. Incisional biopsy confirmed a TCR‐delta+, CD8+ cytotoxic T‐cell lymphoproliferative disorder (TCLPD) compatible with PCGD‐TCL. She achieved complete remission following pralatrexate and subsequent allogeneic hematopoietic stem cell transplant. Case 2 is a 27‐year‐old woman with DM on mycophenolate/rituximab who developed subcutaneous nodules with an indolent course and some spontaneous regression. A biopsy revealed a similar panniculitic infiltrate with an atypical TCR‐delta+, CD8+ phenotype. Notably, both cases were negative for high‐risk JAK/STAT pathway mutations. These cases identify PCGD‐TCLPD/TCL as a potential complication of chronic, immunosuppressed DM. The shared, atypical CD8+ immunophenotype and absence of canonical driver mutations suggest a distinct pathogenic mechanism possibly linked to long‐term immune modulation. Unlike classic PCGD‐TCL, which is characterized by an aggressive course and < 2‐year median survival, the clinical courses in these two cases were variable, with one requiring transplant and the other showing indolent behavior and responsiveness to therapy.