Abstract
A 45-year-old woman presented with scaly erythema on her trunk and extremities and a swelling of her left lower leg, both of which were noticed 6 years ago. A biopsy specimen from the skin showed intraepidermal infiltration of atypical lymphocytes, the finding consistent with patch-stage of mycosis fungoides (MF) . Infiltration of the same small atypical lymphocytes was also observed in the fascia and the muscle of her left lower leg associated with prominent granulomatous reaction containing many multinuclear giant cells.
Immunohistochemistry showed that surface phenotypes of atypical lymphocytes infiltrating skin as well as muscle were CD3+, CD4+, CD5+, CD45RO+, CD8-, CD56-, TIAI-, and granzymeB-. Southern blot and PCR analysesshowed evidence of a clonal T-cell receptor rearrangement in skin specimens, but the results were ambiguous in muscle samples. No other visceral lesion was not detected. There was no evidence of either sarcoidosis or tuberculosis. Psoralen plus ultraviolet A therapy was effective for the skin lesion, but 30Gy of X-ray irradiation to the left lower leg made no response. The possible implications of the coexistence of the two separate lesions in the skin and the muscle were discussed. [Skin Cancer (Japan) 2003; 18: 255-258]
