Authors
Gioia Di Stefano, Vieri Grandi, Virginia Alba Colantuono, Chiara Frattini, Benedetta Peruzzi, Roberto Caporale, Nicola Pimpinelli, Raffaella Santi
Published in
Frontiers in oncology. Volume 16. Pages 1890945. Epub Jul 27, 2026.
Abstract
Mycosis fungoides (MF) shows a broad clinical spectrum, ranging from indolent disease to aggressive variants with poor outcomes. T Follicular Helper (TFH) marker expression has been reported in a subset of MF, with uncertain prognostic significance, while GATA3 has emerged as a potential adverse prognostic marker in MF and nodal T-cell lymphomas. Herein, we report a case of MF investigated through sequential histopathological and phenotypic analyses, including extended TFH markers and GATA3 immunohistochemistry. Initially diagnosed as conventional MF, the disease evolved after 3 years into MF with large cell transformation and leukemic involvement, characterized by prominent folliculotropism, a TFH phenotype, and diffuse GATA3 expression. Retrospective analysis of the initial biopsy identified a minor TFH/GATA3-positive neoplastic population (10%) already present at onset, supporting a model of progressive phenotypic plasticity evolving over time. This case underscores the biological heterogeneity of MF, suggesting that a TFH phenotype and GATA3 expression may help identify patients with a more aggressive disease course, potentially amenable to mogamulizumab-based targeted immunotherapy. Incorporating extended TFH markers and GATA3 into routine immunohistochemical assessment could refine risk stratification and inform treatment decisions.
PMID:
42577277
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.
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