CD4+, CD56+ Mycosis Fungoides: Case Report and Review of the Literature

This case report details an 85-year-old woman who presented with mycosis fungoides (MF), clinical stage IA. Bilateral lesions on the upper thighs were responsive to topical steroid therapy. Biopsies showed band-like dermal infiltrates of medium-sized lymphocytes with marked epidermotropism, including large intraepidermal lymphocytes with nuclear convolutions, consistent with MF Immunohistochemical staining revealed that the lesional cells were CD56(+), but unlike the case in previous reports of CD56(+) MF, they also expressed CD4 and T-cell intracellular antigen 1 and did not express CD8. To our knowledge, this is the first description of a case of MF with a CD4(+), CD8(-), CD56(+), T-cell intracellular antigen I-positive immunophenotype. At 85 years of age, the patient is older than all previously described patients with CD56(+) MF Despite an immunophenotype observed more commonly in aggressive forms of cutaneous T-cell lymphoma, the clinical presentation is that of typical ME The patient presented with limited disease and after 12 months of follow-tip has not progressed beyond stage 1A.