title: Correlations between clinical and pathological features in 17 cases of mycosis fungoides before and after transformation.
abstract: BACKGROUND
  Mycosis fungoides (MF) may progress to transformed MF (T-MF), a condition with aggressive behavior.
  
  
  OBJECTIVE
  This study was designed to compare the clinical and pathological features of biopsies in 17 cases of MF before and after transformation.
  
  
  METHODS
  During a revision of primary cutaneous T cell lymphomas, 53 cases of MF were identified, including 17 cases of T-MF. Clinical, pathological, and immunohistochemical data for the MF patients were evaluated. Cases of T-MF and intermediate transformed (IT) MF were diagnosed according to previous criteria. The histological and immunohistochemical features of T-MF biopsies were compared with those of MF/IT-MF biopsies taken before or concomitant with transformation.
  
  
  RESULTS
  At the initial diagnosis, three patients were found to have more advanced stages of disease: two had MF and T-MF simultaneously, and another had only oral T-MF. Four patients considered to show histological transformation maintained disease stages Ia and Ib and all remain alive. Of five patients with IT-MF at first diagnosis, all progressed to complete histological transformation, three developed tumors, and two died of disease. Four patients progressed to CD30+ large cell lymphoma, and three of these died of disease. In one of these patients, the MF biopsy showed a high level of expression of CD30 in the epidermis and dermis.
  
  
  CONCLUSIONS
  No correlation between advanced MF and expression of CD25 and CD30, or frequency of Ki-67+ cells was found. The frequency of transformation among patients with initially non-transformed MF was high. Our findings support the emphasis given by other authors to IT-MF, a pattern of MF which is generally not considered in many studies.
authors.affiliation: Department of Pathology, Federal University of Bahia, Salvador, Brazil.
authors.forename: Achiléa L
authors.initials: AL
authors.lastname: Bittencourt
authors.affiliation: Federal University of Bahia, Salvador, Brazil.
authors.forename: Pedro D
authors.initials: PD
authors.lastname: Oliveira
authors.affiliation: Department of Pathology, Federal University of Bahia, Salvador, Brazil.
authors.forename: Agnes
authors.initials: A
authors.lastname: Carvalho-Andrade
authors.affiliation: Department of Pathology, Federal University of Bahia, Salvador, Brazil.
authors.forename: Iguaracyra
authors.initials: I
authors.lastname: Araújo
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen / Q000276:immunology / Q000378:metabolism; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology* / Q000503:physiopathology*; D009361:Neoplasm Invasiveness / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000503:physiopathology*
chemical_list: D017730:Ki-1 Antigen