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April 1978

Mycosis Fungoides With Blast Cell Transformation

Author Affiliations

From the Rupert Hallam Department of Dermatology, Hallamshire Hospital (Dr Harrington) and the Academic Division of Pathology, University of Sheffield Medical School (Dr Slater), Sheffield, England.

Arch Dermatol. 1978;114(4):611-612. doi:10.1001/archderm.1978.01640160083026

An unusual case of mycosis fungoides underwent apparent blast cell transformation after two years and the patient died in a leukemic state.

Report of a case  A 57-year-old man had a six-month history of raised red patches on the trunk and limbs. The clinical diagnosis of mycosis fungoides was confirmed by a skin biopsy specimen that demonstrated Daurier-Pautrier epidermal abscesses and a dermal "band-like" infiltrate of mixed mononuclear cells, including large and small hyperchromatic mycosis cells.1,2 The initial lesions responded to ultraviolet light and topical fluocinonide and new lesions that appeared after seven months were treated with cyclophosphamide, prednisolone sodium phosphate, and local radiotherapy (total 4,000 R). Eighteen months later, results of the liver function tests became abnormal and inguinal lymphadenopathy developed. Two ten-day courses of chemotherapy (cyclophosphamide, vincristine sulfate, procarbazine hydrochloride, and prednisolone) were administered, but the third course was terminated owing to the development of pancytopenia. During