Systemic diseases often have varied otolaryngologic manifestations. Mycosis fungoides is a T-cell lymphoma that is often limited to cutaneous involvement but has occasional systemic spread. Careful physical examination and appropriate laboratory studies are keys to establish the diagnosis. We present a case of this unusual entity involving the oropharynx.
A 36-year-old man with a 4-year history of mycosis fungoides stage IIB presented to the otolaryngology clinic in January 2005 with a 1-month history of throat pain. He had initially presented with cutaneous lesions in June 2000, and immunohistochemical analysis of a skin shave biopsy specimen obtained at that time confirmed a diagnosis of mycosis fungoides with CD4+, CD8− cell markers. He was treated with a 3-month regimen of bexarotene (Targretin) and interferon, which resulted in hyperlipidemia and hypothyroidism. The cutaneous lesions persisted, and the patient underwent therapy with interferon and psoralen–UV-A for residual disease in February 2001.