case_images: PMC10704267_01
case_images: Mycosis fungoides with large cell transformation. Biopsy of tumors from both patients (A) 1 and (B) 2 reveal a dense pandermal lymphocytic infiltrate. Large cell transformation was noted in both biopsies with cytologic atypia of lymphocytes, large cells comprising >25% of the infiltrate and admixed eosinophils (C, patient 1; D, patient 2). In patient 1, immunohistochemistry confirmed CD45RO+/CD45RA-/CD20- T cells with CD30 expression in large forms (not shown), and similarly in patient 2, the malignant lymphocytes were CD45RO+/CD3+ T cells (E, CD45RO shown), (F) with CD30 expression. (A, B, C, D, E, and F, Hematoxylin-eosin stain; original magnification: A, x40; B, x40; C, x400; D, x400; E, x200; F, x400).
case_images: gr1.jpg
case_images: PMC10704267_02_gr1.jpg
case_images: fig1
case_images: Biopsy revealed a pandermal atypical lymphocytic infiltrate, with large forms comprising >25% of the cells (Fig 1).
case_images: Patient 1. A, C, E, and G, Resolution/significant improvement of tumors after intralesional doxorubicin. B, D, F, and H, Preinjection images are shown in the left column. Posttreatment in the right column. Although intralesional doxorubicin helps existing lesions, it does not prevent new lesions. B, A new tumor arising on the right eyebrow.
case_images: gr2.jpg
case_images: PMC10704267_01_gr2.jpg
case_images: fig2
case_images: Although plaques responded, tumors progressed (Fig 2, left column). After 8 treatments, improvement was noted, with significant flattening of lesions (Fig 2, right column).
case_images: PMC10704267_02
case_images: Mycosis fungoides with large cell transformation. Biopsy of tumors from both patients (A) 1 and (B) 2 reveal a dense pandermal lymphocytic infiltrate. Large cell transformation was noted in both biopsies with cytologic atypia of lymphocytes, large cells comprising >25% of the infiltrate and admixed eosinophils (C, patient 1; D, patient 2). In patient 1, immunohistochemistry confirmed CD45RO+/CD45RA-/CD20- T cells with CD30 expression in large forms (not shown), and similarly in patient 2, the malignant lymphocytes were CD45RO+/CD3+ T cells (E, CD45RO shown), (F) with CD30 expression. (A, B, C, D, E, and F, Hematoxylin-eosin stain; original magnification: A, x40; B, x40; C, x400; D, x400; E, x200; F, x400).
case_images: gr1.jpg
case_images: PMC10704267_02_gr1.jpg
case_images: fig1
case_images: Biopsy revealed a pandermal atypical lymphocytic infiltrate, with large forms comprising >25% of the cells (Fig 1).
case_images: Patient 2. A, Significant tumor formation, ulceration, and induration of the breast in mycosis fungoides with large cell transformation. B, Near complete resolution of course of intralesional doxorubicin. Patient discontinued phototherapy for her vitiligo, with rapid worsening.
case_images: gr3.jpg
case_images: PMC10704267_02_gr3.jpg
case_images: fig3
case_images: One year later, she developed painful ulcerating tumors on the right breast (Fig 3, A). After 10 sessions, there was significant healing of ulceration and markedly decreased induration (Fig 3, B).