ABSTRACT
Three patients with mycosis fungoides, who were long-term employees of a manufacturer of solid fuel propellants, were seen. Two of these patients had tumorous involvement of the central nervous system, which was successfully treated with radiation therapy. The potential relationship of carcinogens is discussed.
Subject(s)
Brain Neoplasms/secondary , Mycosis Fungoides/chemically induced , Occupational Diseases/chemically induced , Skin Neoplasms/chemically induced , Brain Neoplasms/radiotherapy , Carcinogens , Humans , Lung Neoplasms/secondary , Male , Middle Aged , Mycosis Fungoides/radiotherapy , Mycosis Fungoides/secondaryABSTRACT
Symptomatic involvement of the larynx by mycosis fungoides is rare. We report a case of mycosis fungoides occurring in the larynx of a 74-year-old man. The laryngeal localization was the first visceral manifestation of the disease to be detected clinically.
Subject(s)
Laryngeal Neoplasms/secondary , Mycosis Fungoides/secondary , Skin Neoplasms , Aged , Humans , Laryngeal Neoplasms/pathology , Male , Mycosis Fungoides/pathology , Neoplasm Invasiveness , Skin Neoplasms/pathologyABSTRACT
Mycosis fungoides is a neoplastic disease with extranodal dissemination most frequently to the lung. The roentgenographic and clinical manifestations in these patients may simulate pneumonia and delay appropriate treatment. Disseminated disease is thought to occur in the setting of involvement of the peripheral blood with the neoplastic cells. A case of rapid pulmonary involvement with mycosis fungoides which simulated pneumonia is presented in which there was no peripheral blood manifestation of the disease.
Subject(s)
Lung Neoplasms/secondary , Mycosis Fungoides/secondary , Pneumonia/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/administration & dosage , Diagnosis, Differential , Doxorubicin/administration & dosage , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/drug therapy , Male , Mycosis Fungoides/diagnostic imaging , Mycosis Fungoides/drug therapy , Prednisone/administration & dosage , Radiography , Skin Neoplasms/drug therapy , Vincristine/administration & dosageABSTRACT
Mycosis fungoides (MF) is an uncommon T-cell lymphoma which characteristically involves the skin. Two patients with MF are described who developed fatal complications secondary to involvement of the gastrointestinal tract. One developed malabsorption due to small intestinal involvement; the other had a massive haemorrhage from an ulcerated nodule of tumour in the stomach. The potential for extracutaneous spread is discussed, and it is emphasized that bowel infiltration should be considered in any patient with MF who develops gastrointestinal symptoms or complications.
Subject(s)
Ileal Neoplasms/secondary , Jejunal Neoplasms/secondary , Mycosis Fungoides/secondary , Skin Neoplasms/pathology , Stomach Neoplasms/secondary , Humans , Ileal Neoplasms/pathology , Jejunal Neoplasms/pathology , Male , Middle Aged , Mycosis Fungoides/pathology , Stomach Neoplasms/pathologyABSTRACT
Facial nerve paralysis developed in a man with tumor-stage mycosis fungoides (MF). Mastoidectomy disclosed that MF had involved the mastoid and middle ear. Meningeal lymphoma, confirmed by the finding of Sézary cells in the CSF, was subsequently established. Autopsy disclosed MF lymphoma in the leptomeninges, medulla, spinal cord, and cranial nerves. A unique feature was the formation of a communicating hydrocephalus. Case reports of 23 patients with MF of the CNS, including 21 autopsies, are reviewed. Practically all had tumor-stage or erythrodermic MF. Atypical mononuclear cells were found ante mortem in the CSF in eight patients. In contrast to other CNS lymphomas, bone marrow involvement was uncommon. Cranial, especially facial, nerve paralyses were often premonitory signs of meningeal lymphomas. Patients with MF having such symptoms should have cytologic examination of the CSF.
Subject(s)
Ear Neoplasms/secondary , Ear, Middle/pathology , Mastoid/pathology , Meningeal Neoplasms/secondary , Mycosis Fungoides/secondary , Skin Neoplasms/pathology , Adult , Facial Paralysis/etiology , Humans , Hydrocephalus/etiology , Male , Meninges/pathology , Meningitis/etiology , Mycosis Fungoides/complications , Mycosis Fungoides/pathology , Skin Neoplasms/complicationsABSTRACT
Central nervous system (CNS) involvement by mycosis fungoides (MF) is rare. This is especially true of metastatic parenchymal involvement. Findings in two patients having the tumorous stage of MF are described. Multiple, well delineated, homogeneously and markedly enhancing nodules were seen in these two patients. The computed tomographic (CT) features of CNS involvement by MF are not specific. The differential diagnosis is discussed. By using CT in patients with MF, we will eventually be able to determine the incidence of CNS involvement in this condition.
Subject(s)
Brain Neoplasms/diagnostic imaging , Mycosis Fungoides/diagnostic imaging , Tomography, X-Ray Computed , Brain Neoplasms/secondary , Humans , Male , Middle Aged , Mycosis Fungoides/secondary , Skin NeoplasmsABSTRACT
A case of cerebral mycosis fungoides co-existing with progressive multifocal leucoencephalopathy presented with dementia. Brain biopsy established the diagnosis of mycosis fungoides after cerebrospinal fluid examinations and computerised tomographic scanning of the brain produced non-specific abnormalities.
Subject(s)
Brain Neoplasms/secondary , Mycosis Fungoides/secondary , Skin Neoplasms/pathology , Biopsy , Brain Neoplasms/pathology , Cerebellum/pathology , Frontal Lobe/pathology , Humans , Hypothalamus/pathology , Leukoencephalopathy, Progressive Multifocal/pathology , Male , Middle Aged , Mycosis Fungoides/pathology , Thalamus/pathologyABSTRACT
In a patient with mycosis fungoides the typical skin lesions showed a good response to oral photochemotherapy (PUVA), which could be confirmed by serial control biopsies. Twelve months after onset of therapy large subcutaneous nodules appeared, whereas the upper skin remained uninvolved. Two months later the patient died with disseminated visceral involvement, whereas skin lesions were minimal. The case reported here shows that improvement of the skin lesions of mycosis fungoides under systemic PUVA-therapy can lead to misjudgement of the actual course of the disease. PUVA-therapy of mycosis fungoides may cause a change of the involved layers, leading from the cutis to the subcutis, i.e. disappearance of epidermotropic plaque-like infiltrates and appearance of subcutaneous nodules and visceral involvement.
