Case Number : CT0080 Adam_Bates

I guess this biopsy is taken from the nodule on the forearm. I can see a dense lymphocytic infiltrate encroaching on the epidermis (1st image), admixed with histiocytes, few esinophils and few neutrophils. 8 can also percieve many cells with large vesicular nuclei and prominent nuclei, thought of anaplastic large cell lymphoma maybe developing against a background of MF (widespread scaly plaques). Will do CD3,4,8 and CD30 and ALK-1.
 

Tumor stage MF vs large anaplastic T cell lymphoma.
 

Thought of lymphomatoid papulosis,mixed cellularity
 

Liked the idea of tumor stage MF suggested by Eman, will add the possibility of large cell transformation in this context.
 

lymphomatoid papulosis Thanks for this nice web site.
 

Tumour stage MF is favoured, with possible blastic transformation (>25% large cells in dermis). The differential diagnosis must also include cutaneous ALCL. I would like to do CD 3 / CD 4 / CD 8 / CD 30 and ALK1 to differentiate.
 

Well done, not an easy case but with this history and histology as you say the correct diagnosis is Mycosis fungoides in transformation.