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Mycosis Fungoides With Blast Cell Transformation

Christine I. Harrington, MB, ChB, MRCP; David N. Slater, B Med Sci, MB, ChB
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From the Rupert Hallam Department of Dermatology, Hallamshire Hospital (Dr Harrington) and the Academic Division of Pathology, University of Sheffield Medical School (Dr Slater), Sheffield, England.


Arch Dermatol. 1978;114(4):611-612. doi:10.1001/archderm.1978.01640160083026
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An unusual case of mycosis fungoides underwent apparent blast cell transformation after two years and the patient died in a leukemic state.

Report of a case  A 57-year-old man had a six-month history of raised red patches on the trunk and limbs. The clinical diagnosis of mycosis fungoides was confirmed by a skin biopsy specimen that demonstrated Daurier-Pautrier epidermal abscesses and a dermal "band-like" infiltrate of mixed mononuclear cells, including large and small hyperchromatic mycosis cells.1,2 The initial lesions responded to ultraviolet light and topical fluocinonide and new lesions that appeared after seven months were treated with cyclophosphamide, prednisolone sodium phosphate, and local radiotherapy (total 4,000 R). Eighteen months later, results of the liver function tests became abnormal and inguinal lymphadenopathy developed. Two ten-day courses of chemotherapy (cyclophosphamide, vincristine sulfate, procarbazine hydrochloride, and prednisolone) were administered, but the third course was terminated owing to the development of pancytopenia. During

REFERENCES

Rappaport H, Thomas LB:  Mycosis fungoides: The pathology of extracutaneous involvement . Cancer 34:1198-1229, 1974;.
Lutzner MA, Hobbs JW, Horvath P:  Ultrastructure of abnormal cells in Sézary syndrome, mycosis fungoides, and parapsoriasis en plaque . Arch Dermatol 103:375-386, 1971;.
Dacie JV, Lewis SM, Catovsky D:  Blood cell cytochemistry and supplementary techniques , in Dacie JV, Lewis SM (eds): Practical Haematology , ed 5. London, Churchill Livingstone, 1975;, pp 120-149.
Schwarze EW, Ude P:  Immunoblastic sarcoma with leukaemic blood picture in the terminal stage of mycosis fungoides . Virchous Arch Pathol Anat 369:165-172, 1975;.
Ledonne JE:  Mycosis fungoides: Report of a case terminating in myelogenous leukaemia . N Engl J Med 250:240-242, 1954;.
Greenberg BR, Peter CR, Glassey F, et al:  A case of T-cell lymphoma with convoluted lymphocytes . Cancer 38:1602-1607, 1976;.

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Rappaport H, Thomas LB:  Mycosis fungoides: The pathology of extracutaneous involvement . Cancer 34:1198-1229, 1974;.
Lutzner MA, Hobbs JW, Horvath P:  Ultrastructure of abnormal cells in Sézary syndrome, mycosis fungoides, and parapsoriasis en plaque . Arch Dermatol 103:375-386, 1971;.
Dacie JV, Lewis SM, Catovsky D:  Blood cell cytochemistry and supplementary techniques , in Dacie JV, Lewis SM (eds): Practical Haematology , ed 5. London, Churchill Livingstone, 1975;, pp 120-149.
Schwarze EW, Ude P:  Immunoblastic sarcoma with leukaemic blood picture in the terminal stage of mycosis fungoides . Virchous Arch Pathol Anat 369:165-172, 1975;.
Ledonne JE:  Mycosis fungoides: Report of a case terminating in myelogenous leukaemia . N Engl J Med 250:240-242, 1954;.
Greenberg BR, Peter CR, Glassey F, et al:  A case of T-cell lymphoma with convoluted lymphocytes . Cancer 38:1602-1607, 1976;.

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