The prognosis of early mycosis fungoides is not influenced by phenotype and T-cell clonality

Massone, Cesare; Crisman, Giuliana; Kerl, Helmut; Cerroni, Lorenzo

doi:10.1111/j.1365-2133.2008.08761.x

Cited by 121 publications

(109 citation statements)

References 38 publications

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“…Survival curves did not identify statistical differences among the groups (6), therefore, it is thought that CD8 + cytotoxic MF should not be considered a separate entity of MF (1). The present case study was classified into group B according to this classification (6). The lesions of the present patient were limited to the skin for more than 10 years, a typical clinical course of conventional MF.…”

Section: Discussionmentioning

confidence: 99%

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CD8+ mycosis fungoides with esophageal involvement: A case report

et al. 2012

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Abstract. Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma and is characterized clinically by an indolent course with slow progression. MF is limited to the skin with widespread distribution, however, extracutaneous involvement of MF occurs during the advanced stages of the disease. Esophageal involvement of MF is a rare event.In the present study, we describe the first documented case of CD8 + MF with esophageal involvement that was endoscopically diagnosed antemortem. A 70-year-old male with a 15-year history of MF presented with difficulty in swallowing. Endoscopic examination revealed a tumorous lesion with ulceration in all regions of the esophagus. Esophagus biopsy demonstrated atypical lymphocytic infiltrates with ulceration. Immunohistochemically, these atypical lymphocytes were positive for CD3, CD8 and cytotoxic granules. Therefore, a diagnosis of CD8 + MF involving the esophagus was made. Extracutaneous involvement of the esophagus in MF is extremely rare and the majority of previously reported cases have been diagnosed postmortem. Only two cases of MF with esophageal involvement endoscopically diagnosed antemortem have been previously reported and this is the first documented case of CD8 + MF with esophageal involvement diagnosed by this method. Early detection of extracutaneous involvement of MF is important for accurate treatment and endoscopic examination is a useful tool for detection of this pathology. IntroductionMycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma accounting for approximately 50% of all primary cutaneous lymphoma (1). MF is characterized clinically by an indolent course with slow progression, over years or occasionally decades, from patches to more infiltrated plaque and eventually tumor stages (1). MF is primarily limited to, but widely distributed on, the skin. However, during the advanced stages of the disease, MF has been identified in various extracutaneous regions, most commonly the lymph node, spleen, liver and lung (2). Esophageal involvement of MF has been previously identified, however cases are extremely rare (2-5).MF is characterized histopathologically by infiltrates of small to medium-sized neoplastic T lymphocytes with cerebriform nuclei demonstrating epidermotropism. The typical phenotype of neoplastic lymphocytes is CD3 + , CD4+ and CD8-(6). CD8 + MF has been identified, however, it is rare (6,7). In the present study, we report the first documented case of CD8 + MF with esophageal involvement that was diagnosed endoscopically antemortem. Patient and methodsCase report. A 70-year-old Japanese male with a 15-year history of MF presented with difficulty in swallowing. From the age of 56 years old, the patient reported observation of a gradually enlarging erythema on his left elbow. Four years following this, the patient was referred to Shiga University of Medical Science Hospital due to enlargement of the erythema across his entire body, accompanied by erosion in specific regions. Biopsy of the erythema led to di...

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Section: Discussionmentioning

confidence: 99%

“…(6). Survival curves did not identify statistical differences among the groups (6), therefore, it is thought that CD8 + cytotoxic MF should not be considered a separate entity of MF (1).…”

Section: Discussionmentioning

confidence: 99%

CD8+ mycosis fungoides with esophageal involvement: A case report

et al. 2012

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“…8,9 None of these phenotypes were shown to have a prognostic impact in MF patch or plaque stage. 10 However, cases of early MF with CD30 expression in early disease stage and a high proliferation rate particularly in the dermal component of the infiltrate have been found to be more aggressive in one study. 11 Loss of markers, particularly CD7, can be observed in MF, but also in inflammatory dermatosis.…”

Section: Immunophenotype and Clonalitymentioning

confidence: 97%

Pathologic Diagnosis of Cutaneous Lymphomas

Kempf

Mitteldorf

2015

Dermatologic Clinics

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Primary cutaneous lymphomas comprise a prognostically heterogeneous group of lymphocytic skin neoplasms, which display a broad spectrum of clinical, histologic, immunophenotypic, and genetic features. The histopathological examination plays an essential role and is often the starting point in the diagnostic workup of cutaneous lymphomas. In most cases, the histopathological and the phenotypic analysis alone are limited to provide a list of differential diagnoses. As a consequence of overlapping clinical, histologic, phenotypic, and genetic features among several entities of cutaneous lymphomas, the clinicopathological correlation is of utmost importance to achieve the final diagnosis.

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“…It must also be borne in mind that the PCR primers cannot be tapped and amplify all possible T-cell receptor gene rearrangements. Depending on the stage of the disease, in paraffin-embedded tissue clonal T-cell populations are detected in only 50-90% of mycosis fungoides cases [23,28]. False-positive results, i.e.…”

Section: Practical Aspectsmentioning

confidence: 99%

“…If intraepithelial neoplastic T-cell infiltrates are CD4-negative, the differential diagnosis should include the possibility of a rare but significantly more aggressive cutaneous T-cell lymphoma, especially CD8-positive cytotoxic T-cell aggressive epidermotropic lymphoma and the γ-δ-T cell lymphoma [7]. Because an otherwise typical MF is occasionally capable of expressing CD8 or other cytotoxic markers, the differential diagnosis should never be done by immunophenotyping alone, but always in conjunction with the clinical scenario [7,23].…”

Section: Practical Aspectsmentioning

confidence: 99%

Practical Aspects Regarding the Histopathological Diagnosis of Early Mycosis Fungoides

Tebeică¹,

Andrei

Zurac

et al. 2016

Romanian Journal of Internal Medicine

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Mycosis fungoides is the most common primary T-cell lymphoma of skin. The disease has a protean clinical and histological presentation in its early patch and plaque stages, when distinction from mimicking inflammatory dermatoses is difficult. Since no single criterion is specific enough, a reliable diagnosis in early stages requires integration of clinical, histopathological and molecular findings. In skin biopsies, the most helpful histologic features are the detection of atypical lymphocytes in the epidermis with minimal epidermal changes, basal alignment of lymphocytes along dermal-epidermal junction and formation of Pautrier microabscesses. An aberrant immunophenotype of T cells and molecular detection of a clonal T-cell population are factors that could allow a more specific diagnosis. This work recapitulates and discusses these features from a practical perspective.

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The prognosis of early mycosis fungoides is not influenced by phenotype and T-cell clonality

Abstract: We conclude that cytotoxic phenotype and detection of monoclonal T-cell receptor-gamma gene rearrangement in early lesions of mycosis fungoides do not have any prognostic significance.

Cited by 121 publications

References 38 publications

CD8+ mycosis fungoides with esophageal involvement: A case report

CD8+ mycosis fungoides with esophageal involvement: A case report

Pathologic Diagnosis of Cutaneous Lymphomas

Practical Aspects Regarding the Histopathological Diagnosis of Early Mycosis Fungoides

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