Rare Variants of Mycosis Fungoides: Syringotropic Mycosis Fungoides

Fig. 62.1

Syringotropic mycosis fungoides. Erythematous, scaly patch with papules on the flank

Fig. 62.2

Syringotropic mycosis fungoides. An alopecic patch with anhidrosis

Pathology

SMF is characterized by a dense lymphocytic infiltrate that surrounds and infiltrates the sweat gland and ductal epithelium (Fig. 62.3). The lymphocytes have characteristic hyperchromatic convoluted nuclei. The epithelium of the sweat glands and ducts shows various degrees of hyperplasia (Fig. 62.4) with luminal obliteration. Folliculotropism and epidermotropism are sometimes encountered.

Fig. 62.3

Syringotropic mycosis fungoides. A dense lymphocytic infiltrate surrounds and infiltrates the sweat gland and ductal epithelium

Fig. 62.4

Syringotropic mycosis fungoides. The atypical lymphocytes infiltrate the hyperplastic epithelium of the sweat glands with luminal obliteration

Immunohistochemistry and Molecular Studies: The lymphocytes express CD2, CD3, CD4, and CD5, with partial or total loss of CD7. TCR gamma gene rearrangement studies may be used to identify monoclonality of the infiltrate.

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