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Journal of the American Academy of Dermatology
Volume 80, n° 6
pages 1704-1711 (juin 2019)
Doi : 10.1016/j.jaad.2019.01.062
accepted : 26 January 2019
Dermatopathology

Follicular mucinosis in patients with hematologic malignancies other than mycosis fungoides: A clinicopathologic study
 

Shamir Geller, MD a, b, , Christian J. Gomez, BA a, c, Patricia L. Myskowski, MD c, Melissa Pulitzer, MD d
a Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York 
b Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel 
c Drexel University College of Medicine, Philadelphia, Pennsylvania 
d Department of Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York 

Reprint requests: Shamir Geller, MD, Dermatology Service, Memorial Sloan Kettering Cancer Center, 16 East 60th St, New York, NY 10022.Dermatology ServiceMemorial Sloan Kettering Cancer Center16 East 60th StNew YorkNY10022
Abstract
Background

Follicular mucinosis (FM), which is defined by mucin accumulation within follicular epithelium, may occur in mycosis fungoides (MF). FM without MF is occasionally reported in systemic hematologic malignancies and may be diagnostically challenging.

Objective

To describe clinicopathologic characteristics of FM in patients with hematologic malignancies other than MF.

Methods

Clinical data and histopathology features were analyzed in patients with FM and hematologic malignancies diagnosed between 1994 and 2017.

Results

A total of 18 patients with FM and systemic hematologic malignancies without cutaneous T-cell lymphoma (CTCL) were identified; 9 of them were discovered after hematopoietic stem cell transplantation. No patients with non–CTCL-associated FM (n = 46 [37 biopsy specimens]) developed CTCL during a mean follow-up of 4.3 years. Of the cases of CTCL associated with FM (n = 44 [31 biopsy specimens]), MF was the most common subtype (n = 38), although other CTCLs were identified. FM in patients with non-CTCL hematologic malignancies differed clinically from those with MF-associated FM, presenting most frequently with erythematous papules (P  < .0001), without plaques (P <.0001), without alopecia (P  = .001), and without histopathologically identified epidermal exocytosis (P  = .013).

Limitations

A retrospective study in a single cancer center.

Conclusions

FM can present in systemic hematologic malignancies, including after hematopoietic stem cell transplantation. Papular lesional morphologic and histopathologic features may help to distinguish these cases from MF.

The full text of this article is available in PDF format.

Key words : CD30+ lymphoproliferative disorders, CTCL, cutaneous T-cell lymphoma, follicular mucinosis, hematopoietic stem cell transplantation, histopathology, MF, mycosis fungoides

Abbreviations used : CTCL, FM, GVHD, HSCT, LPD, MF, MSKCC



 Funding sources: This research was funded in part through National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748.
 Conflicts of interest: None disclosed.



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