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Large Cell Transformation in Mycosis Fungoides (MF): The transformed large cells have a blast-like appearance with vesicular nuclei and prominent nucleoli. Mitotic activity is brisk.

The pathogenesis of large cell transformation is poorly understood. Several individual events have been noted. There is overexpression of p53 in the absence of p53 mutations. There is also overexpression of several micro-RNAs. Loss of CDKN2A/CDKN2B has been described. How these events interact and relate to the process of transformation is not yet known.

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