Clinicopathological Evaluation and Outcome of Mycosis Fungoides
Science Journal of Clinical Medicine
Volume 3, Issue 4, July 2014, Pages: 65-69
Received: Jun. 26, 2014;
Accepted: Jul. 10, 2014;
Published: Jul. 20, 2014
Views 2702 Downloads 206
Ilkin Zindanci, Department of Dermatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul - Turkey
Mukaddes Kavala, Department of Dermatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul - Turkey
Ebru Zemheri, Department of Pathology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul – Turkey
Emek Kocaturk, Department of Dermatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul - Turkey
Burce Can, Department of Dermatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul - Turkey
Zafer Turkoglu, Department of Dermatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul - Turkey
Melek Koc, Department of Dermatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul - Turkey
Seyma Ozkanli, Department of Pathology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul – Turkey
Filiz Topaloglu, Department of Dermatology, Bartin State Hospital, Bartin - Turkey
Follow on us
Although mycosis fungoides is the most common cutaneous T-cell lymphoma, its etiopathogenesis has not been clarified definitively and there is no standard and curative treatment method. Medical records of 57 patients diagnosed with mycosis fungoides by clinical and histopathological findings were retrospectively reviewed in our clinic. Complete blood count, erythrocyte sedimentation rate, peripheral blood smear, biochemical findings, chest radiographs, and computerized tomography of all patients were reviewed; patients were staged using TNM system. The clinical presentation was classical patch/plaque form in 44patients and other forms in 13. According to TNM staging, 9patients were stage 1a, 38 were stage 1b, 5 were 2a, and 2 were stage 3, and 2 were stage 4a. The pathological findings were basal alignment of lymphocytes, reticular fibroplasia, atypical lymphocytes, and epidermotropism. Remission was achieved by topical imiquimod in 2patients, phototherapy in 30, and phototherapy and systemic treatment in 8. Remission rate with narrow band UV B was 72%, and that of psoralen UV A was 85.71%. Ten patients in remission had recurrence. Age, sex, duration of disease, and clinical presentation had no effect on remission or recurrence of mycosis fungoides. Reticular fibroplasia is a supporting histopathological finding in mycosis fungoides, together with basal alignment of lymphocytes, atypical lymphocytes and epidermotropism. Topical imiquimod treatment for local lesions and phototherapy for widespread lesions are effective, and psoralen UVA treatment seems to be more efficient than narrow band UVB.
Mycosis Fungoides, Histopathology, Epidemiology, Remission, Recurrence
To cite this article
Clinicopathological Evaluation and Outcome of Mycosis Fungoides, Science Journal of Clinical Medicine.
Vol. 3, No. 4,
2014, pp. 65-69.
Willemze R: Cutaneous T-cell lymphoma. Dermatology. In: Bolognia J, Jorizzo J, eds. 2nd ed. Spain: Mosby, 2008: 1867-1886.
Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood 2007; 110: 1713-1722.
Koh HK, Charif M, Weinstock MA. Epidemiology and clinical manifestations of cutaneous T-cell lymphoma. Hematol Oncol Clin North Am 1995; 9: 943-960.
Siegel RS, Pandolfino T, Guitart J, Rosen S, Kuzel TM. Primary cutaneous T-cell lymphoma: review and current concepts. J Clin Oncol 2000; 18: 2908-2925.
Takaoki I, Yuko T, Michihito N. Cutaneous lymphoma in Tokyo: analysis of 62 cases in dermatology clinic. Int J Dermatol 2001; 40: 37-40.
vanDoorn R, Van Haselen CW, van Voorst Vader PC, Geerts ML, Heule F, de Rie M, Steijlen PM, Dekker SK, van Vloten WA, Willemze R. Mycosis fungoides: disease evolution and prognosis of 309 Dutch patients. Arch Dermatol 2000; 136: 504-510.
Ku LS, Lo KK. Mycosis fungoides--a retrospective study of 40 cases in Hong Kong. Int J Dermatol 2005; 44: 215-220.
Zackheim HS, McCalmont TH, Deanovic FW, Odom RB. Mycosis fungoides with onset before 20 years of age. J Am Acad Dermatol 1997; 36: 557-562
Anadolu RY, Birol A, Sanli H, Erdem C, Tursen U. Mycosis fungoides and Sezary syndrome: therapeutic approach and outcome in 113 patients. Int J Dermatol 2005; 44: 559-565.
Tan ES, Tang MB, Tan SH. Retrospective 5-year review of 131 patients with mycosis fungoides and Sézary syndrome seen at the National Skin Centre, Singapore. Australas J Dermatol 2006; 47: 248-252.
Quaglino P, Zaccagna A, Verrone A, Dardano F, Bernengo MG. Mycosis fungoides in patients under 20 years of age: report of 7 cases, review of the literature and study of the clinical course. Dermatology 1999; 199: 8-14.
Jörg B, Kerl H, Thiers BH, Bröcker EB, Burg G. Therapeutic approaches in cutaneous lymphoma. Dermatol Clin 1994; 12: 433-441.
Baykal C, Büyükbabani N, Kaymaz R. Familial mycosis fungoides. Br J Dermatol 2002; 146: 1108-1110.
Guitart J, Kennedy J, Ronan S, Chmiel JS, Hsiegh YC, Variakojis D. Histologic criteria for the diagnosis of mycosis fungoides: proposal for a grading system to standardize pathology reporting. J Cutan Pathol 2001; 28: 174-183.
Kural YB, Su O, Onsun N, Uras AR: Atopy, IgE and eosinophilic cationic protein concentration, specific IgE positivity, eosinophil count in cutaneous T Cell lymphoma. Int J Dermatol. 2010 Apr;49(4):390-5.
Vidulich KA, Talpur R, Bassett RL, Duvic M. Overall survival in erythrodermic cutaneous T-cell lymphoma: an analysis of prognostic factors in a cohort of patients with erythrodermic cutaneous T-cell lymphoma. Int J Dermatol 2009; 48: 243-252.
Diederen PV, van Weelden H, Sanders CJ, Toonstra J, van Vloten WA. Narrowband UVB and psoralen-UVA in the treatment of early-stage mycosis fungoides: a retrospective study. J Am Acad Dermatol 2003; 48: 215-219.
Ponte P, Serrão V, Apetato M. Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides. J Eur Acad Dermatol Venereol 2010; 24: 716-721.