Mycosis fungoides staged by 18F-flurodeoxyglucose positron emission tomography/computed tomography

Abstract

Introduction:Mycosis fungoides is a kind of malignant lymphoma arising from T cells, but primarily occurs in skin, and it is the most common type of cutaneous lymphoma. Mycosis fungoides (MF) is a rare non-Hodgkin lymphoma but the most common type of primary cutaneous T-cell lymphomas. Because of unknown etiology and mechanism, and lack of typical clinical and histophysiological manifestations, the final diagnosis of MF is currently dependent on pathology and immunohistochemistry. Subsequently, tumor staging is very important. Different approaches would be taken according to varying degrees of cutaneous and extracutaneous lesions. Computed tomography (CT) scan has been chosen to stage tumors customarily. However, CT could only provide morphological information and analyze lymphadenopathy by the size criteria. 18F-flurodeoxyglucose positron emission tomography/computed tomography (PET/CT) could provide morphological information and metabolic conditions simultaneously, which is helpful to locate and stage lesion.Conclusion:18F-flurodeoxyglucose PET/CT could identify cutaneous and extracutaneous lesions in patients with MF. It could provide the range of lesions and biopsy target.

F-18-FDG PET/CT findings of paraneoplastic dermatoses

“…Local skin involvement of malignant neoplasms has been reported in patients with gastric, breast, lung, and uterine cancers [ 4 , 5 ]. Primary cutaneous lymphomas without involvement of lymph nodes, bone marrow or viscera are a heterogeneous group of lymphoproliferative neoplasms, and may mimic erythroderma or panniculitis [ 52 – 57 ]. Sixty five % of primary cutaneous lymphomas originate from mature T lymphocytes, 25% from mature B cells and the remaining part comprises neoplasms of natural killer cells [ 52 – 57 ].…”

“…Primary cutaneous lymphomas without involvement of lymph nodes, bone marrow or viscera are a heterogeneous group of lymphoproliferative neoplasms, and may mimic erythroderma or panniculitis [ 52 – 57 ]. Sixty five % of primary cutaneous lymphomas originate from mature T lymphocytes, 25% from mature B cells and the remaining part comprises neoplasms of natural killer cells [ 52 – 57 ]. They include mycosis fungoides, Sézary syndrome, primary cutaneous peripheral T cell lymphoma, primary cutaneous anaplastic large cell lymphoma, subcutaneous panniculitis-like T cell lymphoma, extra-nodal NK/T cell lymphoma, and nasal-type, etc.…”

“…Only a few studies and case reports evaluate the potential role of FDG PET/CT in diagnosing primary cutaneous lymphomas [ 52 – 57 ]. Several studies indicate that FDG PET/CT is more accurate than CT in detecting both cutaneous and extra-cutaneous diseases of T cell lymphomas including mycosis fungoides [ 52 – 54 ].…”

“…Only a few studies and case reports evaluate the potential role of FDG PET/CT in diagnosing primary cutaneous lymphomas [ 52 – 57 ]. Several studies indicate that FDG PET/CT is more accurate than CT in detecting both cutaneous and extra-cutaneous diseases of T cell lymphomas including mycosis fungoides [ 52 – 54 ]. We have experienced a total of 8 patients with primary cutaneous lymphomas (including 2 patients of mycosis fungoides), all of which showed FDG-avid cutaneous lesions (Fig.…”

CD4/CD8 dual-positive mycosis fungoides

“…MF can develop to involve the lymph nodes, peripheral blood, and viscera. [ 2 ] The 3 typical cutaneous stages of MF are patches, infiltrated plaques, and tumors. [ 3 ] Due to the nonspecific clinical manifestations, MF diagnosis is not easy to confirm in the early stages, resulting in improper medical treatment.…”