Systemic follicular lymphoma mimicking typical histological pattern of mycosis fungoides

Follicular lymphoma (FL) is typically presented in the form of lymphadenopathy, hepatosplenomegaly, and bone marrow infiltration. Herein, we report a case of systemic FL first presenting with a generalized asymptomatic rash with histological features of a superficial band-like lymphoid infiltrate and areas of epidermotropism. Immunohistological studies revealed a B-cell lineage of the atypical lymphocytes. FL was diagnosed through a flow cytometric analysis of the bone marrow aspirate. As per our literature review, this is the first reported case of a systemic FL with secondary cutaneous involvement mimicking the stereotypical histological pattern of mycosis fungoides.