We report 3 patients with granulomatous cutaneous T-cell lymphoma (CTCL) wh
o showed necrobiosis histologically with palisading granulomas. Although gr
anulomatous change may be present in up to 4% of cases of CTCL, necrobiosis
is rare. Misdiagnosis may occur if epidermotropism is minimal or if atypic
al cells are masked by the granulomatous infiltrate. T-cell receptor gene a
nalysis confirmed the presence of clonal T-cell populations in lesional ski
n from all 3 cases.