Staging procedures in mycosis fungoides

Area of Science:

• Dermatology
• Oncology
• Surgical Pathology

Background:

• Mycosis fungoides (MF) is a type of cutaneous T-cell lymphoma.
• Extracutaneous involvement of MF in deep-seated organs can impact treatment response.
• Topical therapies may be less effective when MF spreads beyond the skin.

Purpose of the Study:

• To investigate the prevalence of deep-seated mycosis fungoides (MF) in lymph nodes, spleen, and liver.
• To assess the association between extracutaneous MF and response to topical therapy.
• To evaluate the utility of surgical staging in determining the extent of disease.

Main Methods:

• Clinical staging of 14 patients with mycosis fungoides.
• Performance of staging laparotomy in all patients.
• Histopathological examination of lymph nodes, spleen, and liver for MF.
• Correlation of findings with clinical presentation (adenopathy, splenomegaly, abnormal spleen scans).

Main Results:

• Mycosis fungoides was detected in the lymph nodes of 3 patients.
• Splenic involvement by MF was found in 4 patients.
• Liver involvement was identified in 2 patients.
• Extracutaneous MF was documented in a significant proportion of patients.

Conclusions:

• Deep-seated mycosis fungoides in lymph nodes, spleen, or liver is associated with poor response to topical treatments.
• Surgical staging is recommended for patients with adenopathy or splenomegaly to assess extracutaneous disease extent.
• Accurate documentation of extracutaneous MF is essential for developing novel therapeutic strategies.