Lombardi Conner V, Glosser Logan D, Hopper Wade, Veria Spiro, Awad Mohammed T, Garg Anu
College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA.
Edward via College of Osteopathic Medicine, Spartanburg, SC, USA.
SAGE Open Med Case Rep. 2022 Oct 24;10:2050313X221131163. doi: 10.1177/2050313X221131163. eCollection 2022.
Mycosis fungoides is the most common cutaneous T-cell lymphoma. It presents a diagnostic challenge due to resemblance with many other dermatologic conditions. The disease typically follows a progression from patches to plaques to skin-based tumors with potential for visceral involvement. Diagnosis is made by clinical presentation and histology. When early diagnosis is made, there is an estimated 88% five-year survival. This report details a 60-year-old Black man diagnosed with stage IIIA mycosis fungoides with a severe degree of cutaneous involvement. This case is unique due to the aggressive large cell transformation and rapid progression to death within 18 months of diagnosis. We highlight the challenge of diagnosing, treating, and monitoring the therapeutic response of mycosis fungoides. Finally, this case calls for a multi-disciplinary approach to treatment and to include mycosis fungoides on the differential diagnosis for patients presenting with a variety of vague, recurrent cutaneous symptoms, especially with patchy dyspigmentation or plaques.
蕈样肉芽肿是最常见的皮肤T细胞淋巴瘤。由于与许多其他皮肤病状况相似，它带来了诊断挑战。该疾病通常经历从斑片到斑块再到皮肤肿瘤的进展过程，并有可能累及内脏。诊断通过临床表现和组织学进行。如果能早期诊断，估计五年生存率为88%。本报告详细介绍了一名60岁的黑人男性，被诊断为IIIA期蕈样肉芽肿，皮肤受累程度严重。该病例独特之处在于发生了侵袭性大细胞转化，并在诊断后18个月内迅速进展至死亡。我们强调了蕈样肉芽肿诊断、治疗及监测治疗反应方面的挑战。最后，该病例呼吁采用多学科方法进行治疗，并将蕈样肉芽肿纳入对出现各种模糊、复发性皮肤症状（尤其是斑片状色素沉着异常或斑块）患者的鉴别诊断中。
