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Eosinophils in the skin—a red herring masking lymphoma: a case series

Eosinophilia, both peripheral and in cutaneous tissue, is not a typical finding in mycosis fungoides; in fact, when faced with a lymphoeosinophilic infiltrate, mycosis fungoides is often not part of initial differential considerations. However, eosinophilia has been described in certain subtypes of...

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Autores principales: Jaque, Alejandra, Mereniuk, Alexandra, Sade, Shachar, Lansang, Perla, Imrie, Kevin, Shear, Neil H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985601/
https://www.ncbi.nlm.nih.gov/pubmed/29899986
http://dx.doi.org/10.1177/2050313X18773127
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author Jaque, Alejandra
Mereniuk, Alexandra
Sade, Shachar
Lansang, Perla
Imrie, Kevin
Shear, Neil H
author_facet Jaque, Alejandra
Mereniuk, Alexandra
Sade, Shachar
Lansang, Perla
Imrie, Kevin
Shear, Neil H
author_sort Jaque, Alejandra
collection PubMed
description Eosinophilia, both peripheral and in cutaneous tissue, is not a typical finding in mycosis fungoides; in fact, when faced with a lymphoeosinophilic infiltrate, mycosis fungoides is often not part of initial differential considerations. However, eosinophilia has been described in certain subtypes of mycosis fungoides, namely, in folliculotropic mycosis fungoides. We describe three challenging cases of folliculotropic mycosis fungoides presenting with varied clinical morphologies and a dense lymphoeosinophilic infiltrate and/or severe hypereosinophilia that obscured the final diagnosis for years. Only after treatment of the eosinophilia were the underlying atypical lymphocytes more apparent on histology and a correct diagnosis made. Thus, when characteristic features of mycosis fungoides are subtle, eosinophils can act as a red herring in terms of clinico-pathologic correlation and may prevent early and accurate diagnosis of mycosis fungoides. We suggest that further studies are needed to evaluate whether treatments to reduce eosinophilia, once other causes have been excluded, may help clear the confounding reactive inflammatory infiltrate and facilitate the diagnosis of mycosis fungoides.
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spelling pubmed-59856012018-06-13 Eosinophils in the skin—a red herring masking lymphoma: a case series Jaque, Alejandra Mereniuk, Alexandra Sade, Shachar Lansang, Perla Imrie, Kevin Shear, Neil H SAGE Open Med Case Rep JCMS Case Reports Eosinophilia, both peripheral and in cutaneous tissue, is not a typical finding in mycosis fungoides; in fact, when faced with a lymphoeosinophilic infiltrate, mycosis fungoides is often not part of initial differential considerations. However, eosinophilia has been described in certain subtypes of mycosis fungoides, namely, in folliculotropic mycosis fungoides. We describe three challenging cases of folliculotropic mycosis fungoides presenting with varied clinical morphologies and a dense lymphoeosinophilic infiltrate and/or severe hypereosinophilia that obscured the final diagnosis for years. Only after treatment of the eosinophilia were the underlying atypical lymphocytes more apparent on histology and a correct diagnosis made. Thus, when characteristic features of mycosis fungoides are subtle, eosinophils can act as a red herring in terms of clinico-pathologic correlation and may prevent early and accurate diagnosis of mycosis fungoides. We suggest that further studies are needed to evaluate whether treatments to reduce eosinophilia, once other causes have been excluded, may help clear the confounding reactive inflammatory infiltrate and facilitate the diagnosis of mycosis fungoides. SAGE Publications 2018-05-31 /pmc/articles/PMC5985601/ /pubmed/29899986 http://dx.doi.org/10.1177/2050313X18773127 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages(https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle JCMS Case Reports
Jaque, Alejandra
Mereniuk, Alexandra
Sade, Shachar
Lansang, Perla
Imrie, Kevin
Shear, Neil H
Eosinophils in the skin—a red herring masking lymphoma: a case series
title Eosinophils in the skin—a red herring masking lymphoma: a case series
title_full Eosinophils in the skin—a red herring masking lymphoma: a case series
title_fullStr Eosinophils in the skin—a red herring masking lymphoma: a case series
title_full_unstemmed Eosinophils in the skin—a red herring masking lymphoma: a case series
title_short Eosinophils in the skin—a red herring masking lymphoma: a case series
title_sort eosinophils in the skin—a red herring masking lymphoma: a case series
topic JCMS Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985601/
https://www.ncbi.nlm.nih.gov/pubmed/29899986
http://dx.doi.org/10.1177/2050313X18773127
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