Upper Dermal Infiltrate:
Close-up View (notice epidermal migration of atypical lymphocytes):
Sezary Cells "Cellules Monstreuses":
Sezary cells are neoplastic T4 cells (rare cases are T8) that target the epidermis and may circulate in blood. Patients present with erythroderma, cutaneous plaques, or nodules, and usually have a prolonged course. The images show the atypical cells accumulating in the upper dermis, migrating into the epidermis, staining with anti-CD (T-cell), and circulating as very large, bizarre Sezary cells called "cellules monstreuses." Cell morphology varies patient to patient, but generally is a large cell with a large, basophilic, convoluted nucleus and relatively scant cytoplasm, occasionally with a necklace of vacuoles around the nucleus. Phototherapy, chemotherapy, and radiation may be used for treatment.
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