Mycosis Fungoides with Focal CD 30 Transformation in an Adolescent

Abstract

Mycosis fungoides is rare in children and adolescents. Large cell transformation in mycosis fungoides is typically seen in adult patients with advanced disease. We describe a 16-year-old girl with patch/plaque stage mycosis fungoides who developed a nodule within one of the plaques, which on histopathology showed large cell transformation, with positive labeling with the CD30 immunostain. To the best of our knowledge, this is the second reported case of mycosis fungoides with CD30+ large cell transformation in a child.

Juvenile mycosis fungoides with large‐cell transformation: Successful treatment with psoralen with ultraviolet A light, interferon‐alfa, and localized radiation

“…[3][4][5] Large-cell transformation in MF is also uncommon, with an incidence of 10%. [6][7][8] Our patient is the fourth reported case of MF with LCT in a pediatric patient and only the second to resolve without hematopoietic stem cell transplantation [8][9][10] (Table 1). He is the first to respond favorably to PUVA, IFN-a, and localized radiation.…”

Mycosis fungoides in pediatric patients: Clinical features, diagnostic challenges, and advances in therapeutic management

“…While CD30 + LCT is associated with better prognosis than CD30‐LCT in adults, it is unknown whether this trend pertains to children . Similar to granulomatous MF, LCT‐MF is rare, with only 4 cases reported in pediatric patients . It has been suggested the presence of granulomatous change or large cell transformation may be associated with more aggressive disease …”

Cutaneous Hematolymphoid and Histiocytic Proliferations in Children

“…Only rarely has such a phenomenon been described in lesions in children. 60,61 In FMF, there is infiltration of the hair follicle epithelium with or without epidermotropism (epidermotropism is more frequently seen). The infiltrate involves the infundibulum of the hair follicle and at times deeper portions of the follicle.…”