Flow cytometry for the diagnosis of mycosis fungoides

The diagnosis of mycosis fungoides (MF) remains difficult even with current immunohistochemical and molecular techniques. Flow cytometry is a technology widely used for the diagnosis of hematologic malignancies in all areas of hematopathology but has not been readily applied for the diagnosis of MF. In this article the Authors review two issues that affect the ability to diagnosis of MF by flow cytometry, lymphocyte cell recovery from skin biopsies and identifying T cell neoplasia through alteration of the normal T cell phenotype. They present data from their recently published study and others that demonstrate that cell recovery is, in fact, adequate for diagnosing MF in the vast majority of cases. Moreover, they illustrate techniques used to identify neoplastic T cells that help in the analysis of skin biopsy specimens suspected of harboring a T cell malignancy. Finally, they discuss the power of flow cytometry for the diagnosis of cutaneous T cell lymphomas (CTCL). They argue that the capabilities of current flow cytometric techniques for the diagnosis of MF should allow for enhanced diagnostic accuracy and classification of CTCLs.