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Granulomatous Mycosis Fungoides (MF): Microscopically, the typical histologic features of MF are present. In addition, there are sarcoid type granulomas with foreign body or Langhans giant cells. The granulomas usually represent a minor component of the lymphoid infiltrate. When granulomas are prominent, the lesion can be mistaken for an inflammatory or infective condition. Special stains should be performed nevertheless to rule out infection. Lymphophagocytosis and elastophagocytosis may be seen.
Some cases of granulomatous MF have palisading histiocytic granulomas resembling granuloma annulare or necrobiosis lipoidica.