Granulomatous mycosis fungoides. Report of two cases and review of the literature

Background Granulomatous mycosis fungoides is an extremely rare type of cut aneous T-cell lymphoma. Two cases are described and checked for clinical, h istological and therapeutic differences to other variants of mycosis fungoi des. Case reports Case 1: a 52-year-old patient with livid plaques covering the whole integument. Histological findings showed granulomas with multinuclear giant cells in addition to a malignant lymphohistiocytic infiltrate (monoc lonal T-cell receptor (TCR) -gamma rearrangement). Despite various chemothe rapeutic regimens, progression to tumour stage was observed. Case 2: an 88- year-old man with plaques and ulcerating tumours on the trunk and head. His tological findings showed malignant T-lymphocyte infiltrate (monoclonal TCR -gamma rearrangement) and granulomas with multinuclear foreign-body giant c ells. Complete regression of all lesions was achieved using both local psor alen-ultraviolet A and electron radiotherapy. Conclusions The diagnosis of a granulomatous mycosis fungoides depends excl usively on the histological demonstration of granulomas. Distinct clinical characteristics are not present. Apart from granuloma formation, no other n oticeable histological features are evident. The presence of granulomas in mycosis fungoides does not have prognostic implications, as cases with aggr essive, but also with a prolonged course have been described.