Granulomatous Mycosis Fungoides with Large Cell Transformation Misdiagnosed as Leprosy
Sujittra Siriphukpong MD*, Penvadee Pattanaprichakul MD*, Panitta Sitthinamsuwan MD**, Ekapun Karoopongse MD***
Affiliation : * Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Granulomatous mycosis fungoides is an unusual histopathological variant of cutaneous T-cell lymphoma
without clinical distinction from classic mycosis fungoides. Symptoms associated with peripheral nerve involvement have
rarely been reported in the literature.
Case Report : The authors described a case of granulomatous MF stage IIB with large cell transformation who initially
presented with leprosy-like condition and chronic left peroneal neuropathy. The patient received six courses of gemcitabine
with greater than 90% improvement of skin lesions. The rest of the lesions were successfully treated with local electron beam
radiation.
Conclusion : Granulomatous MF with neuropathy can be clinically misdiagnosed if there is no histopathological and
immunohistochemical finding to support the diagnosis of lymphoma.
Keywords : Granulomatous mycosis fungoides, Large cell transformation, Granuloma annulare-like, Leprosy
