Principles and Pitfalls in Evaluating Early Mycosis Fungoides: Redefining Criteria and Emphasizing Mimics
Journal Title: Indian Journal of Pathology: Research and Practice - Year 2018, Vol 7, Issue 1
Abstract
Background: The diagnosis of early Mycosis Fungoides (MF) is quite challenging because of its overlapping clinicopathologic findings with various reactive dermatoses. A comprehensive assessment of clinical history is absolutely essential as pathologic criteria alone are insufficient. Aim: We aimed to diagnose early MF seeking an algorithm proposed by the International Society for Cutaneous Lymphoma (ISCL), define various significant diagnostic criteria and describe the associated clinical and histological mimics. Materials and Methods : Formalin fixed, paraffin embedded and H&E stained sections of forty skin biopsies from thirty nine clinically suspected early MF patients (n = 39) were studied initially. Various clinical and histopathological parameters were recorded followed by immunohistochemistry (IHC) with selected markers to arrive at a proper diagnosis. Results: Early MF was diagnosed in 9 patients (23.1%), parapsoriasis in 5 patients (12.8%), psoriasiform dermatitis in 7 patients (17.9%) and spongiotic dermatitis in 5 patients (12.8%). Remaining 13 patients (33.3%) were grouped under miscellaneous category comprising of other reactive dermatoses. Atypical lymphocytes were seen in 8 patients with early MF (n = 9) and 2 patients with parapsoriasis (n = 5). No statistical significance was observed between the two groups (P > 0.05, Fisher’s exact test). Conclusions: Some patients with early MF fail to show the typical histological features of the disease. In such instances, multiple biopsies from different lesions are highly useful and the algorithm developed by ISCL is a valid tool in diagnosis. Epidermotropism is considered as histological hallmark. IHC is not needed in all cases, particularly when the clinical and histopathological features are quite obvious.
Authors and Affiliations
Chokka Mahesh Kiran
Keywords
Related Articles
- EP ID EP512011
- DOI 10.21088/ijprp.2278.148X.7118.7
- Views 85
- Downloads 0
A Study of Platelet Indices In Healthy And Sick Neonates
Introduction: The platelet number alone does not give a complete picture of platelet maturity and function. Therefore, platelet indices have been the subject of intensive study in recent years, but they have not been fir...
Cyto–Histopathological Correlation of Various Thyroid Lesions and Evaluation of the Bethesda System for Reporting Thyroid Cytopathology: A 3 Year Retrospective Study
Background: Fine Needle Aspiration Cytology (FNAC) is important for pre-operative and pre-treatment diagnosis of benign and malignant thyroid lesions, thus decreasing the incidence of unwanted surgeries. Objectives: The...
FNAC Study of Tuberculosis among HIV Patients: Descriptive Study
Introduction: Clinical studies have shown the detrimental effects of tuberculosis on the course of HIV infection. The risk of death in HIVinfected patients with tuberculosis was reported to be twice that in HIVinfected...
Study of Spectrum of Infections on Cervicovaginal Smears in a Rural Setting
Background: Cervical infections are commonly encountered problems occurring in the women of the reproductive age group. Pap smear, a screening test for carcinoma cervix is a simple, quick test that can also be used for d...
Correlation of Absolute Lymphocyte Count and CD4 Counts in HIV Infected Patients at a Tertiary Care Institute
Introduction: In HIV infected individuals, CD4 T cell counts along with viral load remains the mainstay for assessing the immune status and for clinical management. As these tests are expensive and not easily available,...