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CASE REPORT
Two faces of gamma–delta mycosis fungoides: before and after renal transplantation
  1. Knut Erich Prillinger1,
  2. Franz Trautinger1,
  3. Melitta Kitzwögerer2,
  4. Johanna Eder1
  1. 1Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, Sankt Pölten, Austria
  2. 2Department of Clinical Pathology, University Hospital St Pölten, Karl Landsteiner University, St Pölten, Austria
  1. Correspondence to Dr Knut Erich Prillinger, knut.prillinger{at}stpoelten.lknoe.at

Summary

We describe a patient with a 30-year history of mycosis fungoides (MF) and renal transplantation performed 3 years before he presented with an ulcerated tumour in the lumbosacral area. Biopsy revealed a lymphatic infiltrate of medium-sized, pleomorphic T cells expressing the gamma–delta T-cell receptor. Radiological staging and bone marrow biopsy revealed no extracutaneous involvement. Despite reduction in systemic immunosuppressants, total skin electron beam radiotherapy and systemic chemotherapy, the disease followed a highly aggressive course and the patient died 31 years after initial diagnosis of MF. Pre-existing MF is not listed as a contraindication for solid organ transplantation. With an ever-increasing number of organ recipients, the number of MF patients undergoing solid organ transplantation will be likely to increase. Systematic collection and analysis of such cases is thus warranted to lead to a better understanding to what kind MF gets influenced by solid organ transplantation and ongoing immunosuppression.

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Footnotes

  • Contributors KEP wrote the manuscript and had the initial idea of writing the article. FT made the diagnosis, cared for the patient and wrote the manuscript. MK did the histopathology and thus contributed significantly to reaching the final diagnosis. JE cared for the patient and wrote the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.