65 yrs female with clinical suspition of mycosis fungoides.  
HISTORY: 2005 06: multiple erythematous confluent eruption in the skin of truncus, back, face, neck, hands and legs. Biopsy from from BREAST skin. Histo: spongiotic dermatitis. Clininal: parapsoriasis. Photodynamic therapy and topicals. Regression of symptoms. NO PHOTOS ARE INCLUDED.  
2006 08: The same eruption from 2006 02. Biopsy from BACK skin. Histo: chronic contact dermatitis. Clininal: parapsoriasis. Follow up (mycosis suspition). Photodynamic therapy and topicals. Regression of symptoms. NO PHOTOS ARE INCLUDED.  
2007 03: Biopsy of the face skin: T lymphoma, most probable Mycosis fungoides (BIOPSY 1- IN PHOTOS).  
2007 04: Tumor in the cheek skin: 9x6cm. Biopsy (BIOPSY 2- IN PHOTOS). Histo: Primary ALCL diagnosed. Radiotherapy to residual tumor. Interferon therapy.  
2008 04: Rebiopsy (BIOPSY 3- IN PHOTOS) from the HAND skin. Extracorporal phoresis and Alemtuzumab- without efect. Now: Intereferon and Acitretin. NO EFFECT.  
Threpine biopsy in 2007 was normal.  
HISTO: 1. Small- medium sized lymphocytic nodular infiltrate in dermis with epidermothropism. 2. More intensive infiltrate with more prominent syringothropism. 3. More deep, more pleomorphic subcutaneous infiltrate and the rest of CD4+ superficial infiltrate (esp in CD4 stain).  
IH: 1. CD3+; CD4+ 10%; GranzymB+ 10%; CD30+ <5%; CD56-.  
IH 2: CD3+; CD2+; CD4+; CD30+ 40%; CD56-; Ki67 90%; GranzymB+ 30%.  
IH 3: CD4+; CD30-; GranzymB+ 5%.  
Proposal/question: Definite nosology of T-NHL: Mycosis fungoides (CD4+ GranB+ CD30+) (tumor stage) in transformation?  
 
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