{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:04:26Z","timestamp":1790211866552,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    CD30\u2010positive large\u2010cell proliferations arising in patients with mycosis fungoides can be diagnostically challenging, particularly when they show variable T\u2010cell receptor expression or gamma\/delta (\u03b3\u03b4) phenotype. We present two cases of mycosis fungoides (MF) with CD30\u2010positive large cell transformation (LCT)\/progression exhibiting \u03b3\u03b4 T\u2010cell phenotypic evolution. Case 1, a 50\u2010year\u2010old woman, initially presented with hyperpigmented patches and papulonodular lesions showing epidermotropic small\u2010cell MF alongside dermal CD30\u2010positive large cells with a \u03b3\u03b4 phenotype. Over ten years, she developed recurrent cutaneous and eventually nodal disease with phenotypic shifts between \u03b3\u03b4 and \u03b1\u03b2 expression, while molecular studies confirmed a single clonal process across all biopsies. Potentially pathogenic variants in\n                    <jats:italic>FAS<\/jats:italic>\n                    and\n                    <jats:italic>CD70<\/jats:italic>\n                    were identified. Case 2, a 72\u2010year\u2010old man with longstanding MF, developed CD30\u2010positive LCT initially with an \u03b1\u03b2 phenotype that subsequently acquired \u03b3\u03b4 expression and DUSP22 rearrangement. Oncoscan microarray revealed shared copy\u2010number alterations including\n                    <jats:italic>CDKN2A\/B<\/jats:italic>\n                    loss across temporally distinct biopsies, and sequencing identified\n                    <jats:italic>KMT2C<\/jats:italic>\n                    and\n                    <jats:italic>TET1<\/jats:italic>\n                    variants. Both cases illustrate that MF can exhibit dynamic T\u2010cell receptor phenotypic evolution, posing significant diagnostic challenges with lymphomatoid papulosis and primary cutaneous \u03b3\u03b4 T\u2010cell lymphoma. Clonal identity confirmation through molecular studies is essential for accurate classification.\n                  <\/jats:p>","DOI":"10.1111\/cup.70221","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:21:56Z","timestamp":1790209316000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gamma\u2010Delta Phenotypic Evolution in Mycosis Fungoides With\n                    <scp>CD30<\/scp>\n                    \u2010Positive Cutaneous Progression"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2512-8158","authenticated-orcid":false,"given":"Sahil","family":"Chaudhary","sequence":"first","affiliation":[{"name":"Department of Pathology University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folashade","family":"Adekunle","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology University of Virginia Comprehensive Cancer Center  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Cropley","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Virginia Medical Center  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrica","family":"Marchi","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Harvard Medical School and Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinbo","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7716-6680","authenticated-orcid":false,"given":"Ifeyinwa E.","family":"Obiorah","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"16","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1182\/blood-2018-11-881268","article-title":"The 2018 Update of the WHO\u2010EORTC Classification for Primary Cutaneous Lymphomas","volume":"133","author":"Willemze R.","year":"2019","journal-title":"Blood"},{"issue":"1","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1038\/s41467-020-15572-7","article-title":"Cellular Origins and Genetic Landscape of Cutaneous Gamma Delta T Cell Lymphomas","volume":"11","author":"Daniels J.","year":"2020","journal-title":"Nature Communications"},{"issue":"5","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/j.jaad.2020.10.012","article-title":"Diagnosis of Gamma\/Delta Mycosis Fungoides Requires Longitudinal Clinical Observation","volume":"85","author":"Ferrier A.","year":"2021","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"2","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jaad.2013.09.007","article-title":"Large\u2010Cell Transformation of Mycosis Fungoides\u2010Differential Diagnosis With Implications for Clinical Management: A Consensus Statement of the US Cutaneous Lymphoma Consortium","volume":"70","author":"Kadin M. 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