Mycosis fungoides diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

Overview

Mycosis fungoides is primarily diagnosed based on the clinical presentation.

Mycosi fungoides must be performed when:^[1]
- Mycosis fungoides is primarily diagnosed based on the clinical presentation.
- The patient presents with symptomatic progressive skin lesions such as: patches, plaques, tumors, and erythroderma, and a poorer prognosis in later stages.
- There is no single diagnostic study of choice for the diagnosis of mycosis fungoides, and mycosis fungoides can be diagnosed difficult by nonspecific skin presentation.
- Disease present with skin lesions not treated by useual medication.

Diagnosis criteria from the International Society for Cutaneous Lymphoma is:^[2]^[3]


Criteria	Major( 2pinots)	Minor(1point)
Persistent and/or progressive patches and plaques plus	Any 2	Any 1
Clinical
1. Non–sun-exposed location
2.Size/shape variation
3.Poikiloderma
Histopathologic
Superficial lymphoid infiltrate plus	Both	Either
1. Epidermotropism
2. Atypia
Molecular/biological
Clonal TCR gene rearrangement		Present
Immunopathologic
1. CD2, CD3, CD5 in <59% of T cells		Any 1
2. CD7 in <10% of T cells
3. Epidermal discordance from expression of CD2, CD3, CD5, and CD7 on dermal T cells

↑ Galper SL, Smith BD, Wilson LD (May 2010). "Diagnosis and management of mycosis fungoides". Oncology (Williston Park, N.Y.). 24 (6): 491–501. PMID 20568590.
↑
↑ Pimpinelli, Nicola; Olsen, Elise A.; Santucci, Marco; Vonderheid, Eric; Haeffner, Andreas C.; Stevens, Seth; Burg, Guenter; Cerroni, Lorenzo; Dreno, Brigitte; Glusac, Earl; Guitart, Joan; Heald, Peter W.; Kempf, Werner; Knobler, Robert; Lessin, Stuart; Sander, Christian; Smoller, Bruce S.; Telang, Gladys; Whittaker, Sean; Iwatsuki, Keiji; Obitz, Erik; Takigawa, Masahiro; Turner, Maria L.; Wood, Gary S. (2005). "Defining early mycosis fungoides". Journal of the American Academy of Dermatology. 53 (6): 1053–1063. doi:10.1016/j.jaad.2005.08.057. ISSN 0190-9622.