Folliculotropic mycosis fungoides with eosinophilia and CD30+ large-cell transformation: a case with a fatal outcome presenting with multifocal lesions and leonine facies.
Eosinophilia is recognized as a poor prognostic factor in patients with cutaneous T-cell lymphoma (CTCL). We report a case of folliculotropic mycosis fungoides (FMF) presenting with multiple ulcerative nodular lesions and persistent eosinophilia. Severe facial lesions resulted in a leonine appearance. On histopathological examination, nodular infiltration of large CD30+ large cells was seen. When the previous biopsy specimens were reviewed, marked folliculotropism with atypical lymphocytes was identified in previous specimens 20 years before the blastic transformation. CC chemokine receptor 3 was expressed in tumour cells, whereas CXC chemokine receptor 3 was negative. Expression of interleukin (IL)-5 was detected in a few mononuclear lymphoid cells. This case demonstrates that T helper (Th)2-polarized tumour cells may produce Th2 cytokines including IL-5, which suggests that cytokines and chemokines may contribute to persistent eosinophilia and to recruitment of eosinophils into tumour lesions in advanced FMF.
Ishibashi
M
M
Department of Dermatology, Saiseikai Central Hospital, Minato-ku, Tokyo, Japan. ishibashi@saichu.jp
Ohshima
K
K
Chen
K R
KR
D000328:Adult; D004802:Eosinophilia / Q000175:diagnosis* / Q000473:pathology; D005153:Facial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D019066:Facies; D017809:Fatal Outcome; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis / Q000473:pathology; D008297:Male; D009182:Mycosis Fungoides / Q000175:diagnosis* / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology