Lymph node grading for staging of mycosis fungoides may benefit from examination of multiple excised lymph nodes.
BACKGROUND
Lymph node (LN) histopathologic class has been shown to be a significant determinant of survival in patients with mycosis fungoides. Often, histopathologic evaluation of just 1 node is used in staging patients with cutaneous T-cell lymphoma.


OBJECTIVE
We examined whether sampling multiple nodes alters the staging and prognostic group placement of patients with mycosis fungoides as compared with sampling just 1 node.


METHODS
Multiple LNs were obtained from a single, local region for histopathologic evaluation and grading in 8 patients with mycosis fungoides.


RESULTS
Differences in histopathologic grading using multiple nodes were found in 5 of 8 patients. There was a potential upstaging of the assigned disease stage, compared with the stage that might have been assigned had just 1 node been sampled, in 3 patients. The differences in LN grading also potentially led to differences in prognostic group placement in 4 patients.


CONCLUSIONS
Determining histopathologic grades from multiple LNs may allow a more accurate stage and prognosis to be assigned to patients.
Department of Dermatology, University of Cincinnati Medical Center, Ohio 45267-0523, USA. debra.breneman@uc.edu
Debra L
DL
Breneman
Uma S
US
Raju
John C
JC
Breneman
Paul E
PE
Steele
David W
DW
McFadden
Hernani D
HD
Cualing
Michael S
MS
Nussbaum
Steven H
SH
Swerdlow
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology*