title: Phenotypic Variation in Different Lesions of Mycosis Fungoides Biopsied Within a Short Period of Time From the Same Patient.
abstract: Phenotypic variants of mycosis fungoides (MF) include mainly the expression of cytotoxic markers by neoplastic cells (either α/β or γ/δ cytotoxic). To manage the patient properly, distinction from other cutaneous cytotoxic natural killer/T-cell lymphomas is paramount. Particularly for cutaneous γ/δ T-cell lymphoma, distinction is often based on clinicopathologic correlation (presence of tumors at first diagnosis as opposed to patches only in MF). The authors report a case of cytotoxic MF characterized by expression of TCRγ in two of three biopsies performed within a time frame of 1 week. The patient presented with patches, plaques, and 1 tumor at the time of first diagnosis; thus, distinction from cutaneous γ/δ T-cell lymphoma was not possible on clinical grounds alone. The diagnosis of MF was established, thanks to the phenotypic variations revealed by the three biopsies, with 1 lacking expression of cytotoxic proteins (TIA-1 and granzyme B) and of TCRγ. This case shows the importance to perform several biopsies in cases of cutaneous lymphoma, as morphologic and phenotypic features are variable and information gathered from a single biopsy may result in a wrong diagnosis.
authors.affiliation: *Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Austria; and †Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Natalie
authors.initials: N
authors.lastname: Kash
authors.forename: Cesare
authors.initials: C
authors.lastname: Massone
authors.forename: Regina
authors.initials: R
authors.lastname: Fink-Puches
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
mesh_terms: D000969:Antinematodal Agents / Q000627:therapeutic use; D001132:Arm; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D053804:Granzymes / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000737:chemistry / Q000276:immunology / Q000473:pathology* / Q000628:therapy; D011701:PUVA Therapy; D010641:Phenotype; D039102:Poly(A)-Binding Proteins / Q000032:analysis; D011237:Predictive Value of Tests; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000032:analysis; D011994:Recombinant Proteins / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000737:chemistry / Q000276:immunology / Q000473:pathology* / Q000628:therapy; D000074019:T-Cell Intracellular Antigen-1; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000969:Antinematodal Agents; D014408:Biomarkers, Tumor; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D039102:Poly(A)-Binding Proteins; D016692:Receptors, Antigen, T-Cell, gamma-delta; D011994:Recombinant Proteins; D000074019:T-Cell Intracellular Antigen-1; C071558:TIA1 protein, human; C509213:GZMB protein, human; D053804:Granzymes