Medical MCQ - A 62-year-old man develops scaling and non-scaling patches, and plaques over his chest and back. They are itchy, but not painful. The rest of the examination is normal, except for lymphadenopathy. Examinations of the blood film and skin biopsy histology, both, reveal unusually large monocytoid cells. Which of the following is the most likely diagnosis?

A 62-year-old man develops scaling and non-scaling patches, and plaques over his chest and back. They are itchy, but not painful. The rest of the examination is normal, except for lymphadenopathy. Examinations of the blood film and skin biopsy histology, both, reveal unusually large monocytoid cells. Which of the following is the most likely diagnosis?

leukemia

visceral B-cell lymphoma

primary cutaneous T-cell lymphoma

viral infection (usually Epstein-Barr)

Question Category:

Medicine

Correct Answer:

primary cutaneous T-cell lymphoma

Description:

These large cells are typical of Sezary syndrome, a leukemic form of cutaneus T-cell lymphoma (CTCL). This is frequently an early presentation of mycosis fungoides or CTCL. There may be a relationship to human T-cell lymphotropic virus (HTLV) I and II, but it is not universal. CTCL is a malignancy of helper T cells (CD4+).

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