Mycosis Fungoides With Unusual Granulomatous Pulmonary Manifestations

Mycosis fungoides is the most common form of cutaneous T-cell lymphoma, with the lungs being the most common site of extranodal involvement. Our patient is a 65 year old woman who was diagnosed with mycosis fungoides and presented with lung parenchymal infiltrates shortly thereafter. Histological examination of the lung lesion revealed an atypical small lymphocytic infiltration along with prominent granulomas and focal angiocentric lesions. Flow cytometry studies confirmed pulmonary involvement by mycosis fungoides. Granulomatous inflammation has been described earlier within the cutaneous infiltrates of mycosis fungoides. However, the presence of granulomas in the lungs involved by mycosis fungoides has only been described in one previous case report. We are reporting the second case of pulmonary involvement by mycosis fungoides with very unusual histologic features including the formation of epithelioid granulomas and angiocentric lesions, supported by flow cytometry studies.