Clinicopathological spectrum of mycosis fungoides type cutaneous T-cell lymphoma.
OBJECTIVE
To determine the clinical, histological, and immunophenotypic characteristics of mycosis fungoides type cutaneous T-cell lymphoma.


METHODS
Descriptive study.


METHODS
This study was conducted from January 2000 to December 2004 at the Department of Dermatology, Military Hospital and the Department of Dermatopathology, Armed Forces Institute of Pathology, Rawalpindi.


METHODS
The medical case records of patients with mycosis fungoides diagnosed during the period of study were surveyed. Data was collected pertaining to patient s characteristics, clinical descriptions, histopathological features, immunophenotypic analysis and stage of disease at the time of diagnosis.


RESULTS
A total of 33 cases of mycosis fungoides were diagnosed between the years 2000 and 2004. There were 24 male and 9 female patients with male to female ratio of 2.6:1 The age ranged from 24 to 68 years and the duration of disease prior to diagnosis varied between 2 to 36 months. The number of skin biopsies performed for definite diagnosis ranged from 01 to 5. The various clinical presentations recorded in these patients were hypopigmented patches in 7 (21.3%), infiltrated papules and plaques in 6 (18.2%), erythroderma in 5 (15.2%), psoriasiform lesions in 3 (9%), and nodular lesions in 3 (9%) patients. There were 2 (6%) cases respectively of noduloulcerative, ichthyosiform and poikilodermatous lesions, and 1(3%) case each of follicular, morphoea-like and purpuric skin lesions. The predominant histological features were lymphocytic infiltrate in the upper dermis, epidermotropism, haloed lymphocytes in epidermis, Pautrier s microabscesses, and interface dermatitis. The immunohistochemical studies (n=12) showed predominantly T helper cell immunophenotype (CD3+, CD45RO+) in 11(92%) cases and T suppressor cell immunophenotype (CD3+, CD8+) in 1(8%) patient.


CONCLUSIONS
The mycosis fungoides type cutaneous T-cell lymphoma has a wide clinicopathological spectrum. In a clinically non-specific dermatosis, a high index of suspicion and a regular follow-up may eventually lead to the definite diagnosis.
Department of Dermatology, Military Hospital, Rawalpindi Cantt.
Zafar Iqbal
ZI
Shaikh
Simeen Ber
SB
Rahman
D000328:Adult; D000368:Aged; D001706:Biopsy; D003625:Data Collection; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D009367:Neoplasm Staging; D012867:Skin / Q000473:pathology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology