{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:03:54Z","timestamp":1792008234221,"version":"4.4.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":355,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"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":["Case Reports in Hematology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Central nervous system (CNS) involvement by cutaneous T\u2010cell lymphomas (CTCL) is exceptionally rare and is associated with a poor prognosis. Folliculotropic mycosis fungoides (FMF) is a rare subtype of CTCL and often has more aggressive clinical behavior compared to classic MF. The risk factors for CNS progression in patients with primary CTCL are not well understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary<\/jats:title>\n                    <jats:p>We present the case of a 75\u2010year\u2010old male with a history of Stage IA FMF, who developed progressive neurologic and functional decline over six months. Workup revealed marked eosinophilia, and CSF analysis showed monoclonal T\u2010cell population with positive T\u2010cell receptor (TCR) gene rearrangement. Flow cytometry further showed an atypical CD4+ T\u2010cell population with loss of CD7, consistent with the immunophenotype of patient\u2019s cutaneous MF, supporting secondary CNS involvement. An MRI of the brain showed T2 hyperintensity in the pons and right middle cerebellar peduncle, with low signal intensity throughout the bone marrow of the skull, concerning for CNS progression of FMF. The patient was started on high\u2010dose steroids, which led to improvement in eosinophilia. Due to transaminitis, high\u2010dose methotrexate therapy was deferred, and the patient was initiated on intrathecal (IT) chemotherapy with methotrexate and cytarabine. Following five cycles of IT chemotherapy, the patient\u2019s neurologic status significantly improved, and CSF analysis showed resolution of the atypical T\u2010cell population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the rare occurrence of CNS progression of FMF, even in the absence of lymphatic involvement and with well\u2010controlled skin manifestations, and underscores the role of IT chemotherapy in managing this complication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crh\/6972475","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T15:47:28Z","timestamp":1766418448000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Central Nervous System Progression in Folliculotropic Mycosis Fungoides"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6918-7908","authenticated-orcid":false,"given":"Cher Ying","family":"Foo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Sanjeevi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harkarandeep","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00296-9"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191461"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410360411"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199912093412407"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2013.09.016"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lrr.2017.10.001"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00130404-200601000-00010"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.09.025"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.08075.x"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2007.07.021"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14387"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.15386\/mpr-1347"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2011-0597-Ra"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/labmed\/lmy035"}],"container-title":["Case Reports in Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/6972475","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crh\/6972475","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/6972475","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:04:20Z","timestamp":1772982260000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crh\/6972475"}},"subtitle":[],"editor":[{"given":"Kalyani","family":"Sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/crh\/6972475"],"URL":"https:\/\/doi.org\/10.1155\/crh\/6972475","archive":["Portico"],"relation":{},"ISSN":["2090-6560","2090-6579"],"issn-type":[{"value":"2090-6560","type":"print"},{"value":"2090-6579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6972475"}}