Histopathological Patterns in Mycosis Fungoides: A Cross-Sectional Study

Mycosis fungoides (MF) represents the most prevalent form of cutaneous lymphoma, characterized by diverse histopathological patterns. However, recent comprehensive studies systematically evaluating the spectrum of histopathological patterns and changes associated with MF in patients within Iran are notably lacking.

This cross-sectional descriptive study analyzed 64 skin biopsy slides diagnosed with MF, archived from 2013 to 2023 at Al-Zahra Hospital and a private dermatopathology laboratory in Isfahan, Iran. Inclusion criteria included all slides with complete demographic data and a confirmed MF diagnosis. Patterns and finding of these slides were analyzed according to age, gender, and biopsy site. Data analysis was performed using SPSS Version 26.0, with significance set at p < 0.05.

The study included 31 females and 33 males, with a mean age of 44.64 ± 14.91 years. The most common biopsy site was the trunk (45.31%). The predominant histopathologic patterns observed were psoriasiform (33 cases), lichenoid (14 cases), and spongiotic (10 cases), with universal epidermotropism across all slides. Parakeratosis and cytological atypia were found in 37 and 31 cases, respectively. Notably, eosinophils were more frequent in males (p=0.016), and cytological atypia were significantly more common in males than females (p=0.044). Mild dermal infiltrate was the most prevalent, particularly in the 35-42 and 43-56 age groups, with a significant age-related variation (p=0.041).

This study reveals that psoriasiform, lichenoid, and spongiotic patterns are the most common in MF, with epidermotropism present in all cases. Age and gender significantly influence certain features, but overall, histopathological patterns showed no significant variation by biopsy location or age group.