Mycosis Fungoides Manifesting as Giant Cell Lichenoid Dermatitis

Abstract

Mycosis fungoides (MF) is the most common form of primary cutaneous lymphoma with a broad clinicopathological spectrum. Unusual histopathologic patterns of MF include lichenoid, interstitial, folliculotropic, spongiotic, granulomatous, and many others. Several cases of unusual lichenoid reaction characterized by a mixed lichenoid inflammatory infiltrate with prominent infiltration of the papillary dermis and epidermis by multinucleated giant cells were described under the name of "giant cell lichenoid dermatitis," most of them were considered to represent a drug eruption. Herein, we describe a 77-year-old woman with a 5-year history of MF displaying microscopic features of giant cell lichenoid dermatitis. Histology revealed a dense band-like lichenoid epidermotropic infiltrate composed of CD4 small to medium-sized lymphocytes with cerebriform nuclei with the presence of multinucleated giant cells in the papillary dermis, within the epidermis, and some hair follicles. Monoclonal TCR gene rearrangement was detected using PCR. To the best of our knowledge, this pattern was never described in MF.

Assessment of cases of lichenoid granulomatous stomatitis in respect to demographics, histological features, and subcategories in known population

“…Lichenoid features can be non-specific and found with other conditions such as systemic diseases and as a response to pre-malignant and malignant oral conditions. Chronic granulomatous inflammation may arise in the oral cavity with numerous etiologic influences such as immunologic agents, foreign material, infective organisms, and manifests with subepithelial collections of histiocytes and giant cells organized into granulomas [6]. It is suggested that lesions not fulfilling all criteria for OLP such as systemic medication use or localized reaction to dental materials come under oral lichenoid lesion (OLL) or oral lichenoid mucositis (OLM).…”