Granulomatous mycosis fungoides. Report of two cases and review of the literature

Abstract

The diagnosis of a granulomatous mycosis fungoides depends exclusively on the histological demonstration of granulomas. Distinct clinical characteristics are not present. Apart from granuloma formation, no other noticeable histological features are evident. The presence of granulomas in mycosis fungoides does not have prognostic implications, as cases with aggressive, but also with a prolonged course have been described.

Complete clinical remission of tumor-stage mycosis fungoides after acute extensive skin necroses, granulomatous reaction, and fever under treatment with bexarotene, vorinostat, and high-dose fenofibrate

“…[1][2][3][4] Clinically, granulomatous MF presents with patches, plaques, and/or tumors and is, with the exception of granulomatous slack skin, indistinguishable from classic MF. The origin, pathogenesis, and biologic significance of granulomatous reactions in cutaneous lymphoma are unknown so far.…”

Granulomatous mycosis fungoides with hypohidrosis mimicking lepromatous leprosy

“…[1] Hodgkin's disease has the highest frequency of granuloma formation among the various lymphomas. It is rarely seen in non-Hodgkin's lymphomas including cutaneous lymphomas.…”

“…[5] Concomitant occurrence of non-neoplastic granulomas with MF like sarcoidosis and granuloma annulare or infectious granulomas may also be considered. [1,6,7] GMF may also be mistaken for leprosy specially in countries like India where leprosy is endemic. This leads to delay in diagnosis and treatment.…”

“…Heterogenous nature of clinical presentation delays diagnosis and consequently diagnosis is based mainly on histopathological features, immunohistochemistry and gene rearrangement studies. [1,2] We report this case for its rarity, association with hypohidrosis, granulomatous lymphadenitis and to highlight its resemblance to lepromatous leprosy.…”

Granulomatous slack skin disease: a new combined proton and photon therapy approach with a reported case response

“…1-3 GSSD has recently been recognised as being a cutaneous lymphoma on the basis of findings of clonal lymphocyte populations in T-cell receptor gene rearrangement studies. In the case of radiotherapy, hiatus to individual lesions in some patients has been reported, 10,11 but the paucity of long-term followup has prevented a determination of efficacy. 6 In addition, there exists a correlation between GSSD and Hodgkin lymphoma, with GSSD patients expressing lymphoma symptoms prior or subsequently to the GSSD.…”