Mycosis fungoides d'emblée: a rare presentation of cutaneous T-cell lymphoma

A case of the d'emblée variant of mycosis fungoides is presented to confirm the validity of this rare variant of cutaneous T-cell lymphoma. The patient had rapidly progressing cutaneous tumors of mycosis fungoides with no internal organ or nodal involvement at the onset of the disease. This was confirmed at a laparotomy, which was done to remove a uterine leiomyoma. The classic light microscopy was confirmed by electron microscopy. Postmortem findings showed a remarkable degree of "epitheliotropism." The d'emblée form of mycosis fungoides has been disputed by some who argue that these cases represent a lymphoma that begins elsewhere and has secondary skin involvement. In this patient there was an opportunity, within a few weeks of the onset of the problem, to do an extensive staging work-up, including laparotomy. No evidence of internal lymphoma was found.