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Childhood Hepatosplenic T-cell Lymphoma with Skin Involvement. BACKGROUND: Hepatosplenic T-cell lymphoma is a rare malignancy in childhood. CASE CHARACTERISTICS: A 12-year-old boy who presented a pyrexia of unknown origin, multiple skin and lesions and marked hepatosplenomegaly. OBSERVATION: Bone marrow aspirate cytology showed no blast cells. Splenectomy was done, and spleen showed infiltration with atypical lymphoid cells positive for CD3, CD8 and T-cell-restricted intracellular antigen. OUTCOME: The skin rash of patient subsided with chemotherapy. MESSAGE: Skin involvement may be an unusual clinical manifestation of hepatosplenic T-cell lymphoma.