Alireza Ghanadan; Kambiz Kamyab; Rokhsareh Yadegar; Mehri Maghsoodi
Abstract
Background and Aim: Mycosis fungoides (MF) is the most common form of primary cutaneous lymphoma, resulting from the infiltration of malignant T cells into skin tissues. The disease has three distinct stages: patch, plaque, and tumor. In the patch and plaque stages, it can mimic the clinical features ...
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Background and Aim: Mycosis fungoides (MF) is the most common form of primary cutaneous lymphoma, resulting from the infiltration of malignant T cells into skin tissues. The disease has three distinct stages: patch, plaque, and tumor. In the patch and plaque stages, it can mimic the clinical features of benign dermatoses. However, two scoring systems facilitate diagnosis at these stages, which will be discussed in more detail in this study.Methods: In this cross-sectional study, all formalin-fixed and paraffin-embedded skin specimens highly susceptible to MF based on clinical examination at the patch and plaque stages were collected from April 2017 to August 2019. They were subjected to H&E and IHC staining tests and examined according to Guitart and Pimpinelli criteria.Results: Out of 78 samples, 76 had histological criteria for MF according to Guitart’s criteria, 54 were immunologically significant according to Pimpinelli’s criteria for MF, and 52 were classified as definitive MF according to both criteria. CD3 and CD4 markers were the most frequent markers, respectively. In contrast to previous studies, the CD7 marker was expressed at 10% or higher in 24 cases. In addition, 65 of 78 samples had a CD8 marker, and only 13 samples were CD8-.Conclusion: In the early stages of MF, a single scoring system does not have sufficient sensitivity for the diagnosis. The triad of the patient’s clinical presentation and histological and immunohistochemical features play a key role in achieving the correct diagnosis.
Fariba Iraji; Fatemeh Mohaghegh; Atefeh Shajari; Parvin Rajabi; Samaneh Mozafarpoor
Abstract
Mycosis fungoides (MF) is the most common skin subtype of T-cell lymphoma. Its underlying cause is not yet clearly understood, and diagnosis might be difficult since MF presents itself with symptoms similar to some other dermatologic disorders. In the current case presentation, we report a 12-year-old ...
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Mycosis fungoides (MF) is the most common skin subtype of T-cell lymphoma. Its underlying cause is not yet clearly understood, and diagnosis might be difficult since MF presents itself with symptoms similar to some other dermatologic disorders. In the current case presentation, we report a 12-year-old female with concurrenthypopigmented and pigmented purpuric dermatosis-like lesions that underwent skin biopsies and immunohistochemistry study. Microscopic findings of hyperkeratosis and mild acanthosis in addition to epidermotropism of lymphocytes with perivascular and interstitial infiltration led us to the probable diagnosis of MF.Intraepidermal lymphocyte immunohistochemistry assessments were positive for CD3 and CD4 while negative for CD8 and CD7. The peripheral blood smear revealed a normal CD4 to CD8 ratio, and the number of Sézary cells detected was insufficient to diagnose Sézary syndrome. Therefore, the final diagnosis of MF was made for this young patient.
Mohammad Shahidi-Dadras; Farnaz Araghi; Fahimeh Abdollahimajd; Mehdi Gheisari; Ali Forghanian; Sahar Dadkhahfar
Abstract
During the current coronavirus disease 2019 (COVID-19) pandemic, patients with malignancies like primary cutaneouslymphomas (PCLs) are considered at high risk for severe disease progression given their underlying condition. Mycosis fungoides (MF) is a type of PCL that often needs lifelong treatments, ...
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During the current coronavirus disease 2019 (COVID-19) pandemic, patients with malignancies like primary cutaneouslymphomas (PCLs) are considered at high risk for severe disease progression given their underlying condition. Mycosis fungoides (MF) is a type of PCL that often needs lifelong treatments, including immunosuppressive drugs that predispose patients to catastrophic COVID-19 outcomes. Accordingly, several issues are to be addressed in the management of patients with MF. First of all, patients with this chronic condition may lose access to healthcare services such as phototherapy and inpatient treatments like electron beam therapy. Secondly, the patients’ anxiety of becoming infected while referring for the follow-up visits might impair their adherence to treatments. Finally, the current situation may affect the management strategies of dermatologists adopted for MF patients.We decided to perform this teledermatology study to assess the clinical condition of patients with MF in our referral center. We also evaluated patients’ perceived anxiety during the COVID-19 pandemic based on the Corona Disease Anxiety Scale (CDAS). Our results demonstrated that lockdown could influence adherence to treatment modalities (especially phototherapy) in these patients.
Nasrin Saki; Fatemeh Sari Aslani; Jalal Hajizadeh; Mohammad Derayesh; Bahareh Kardeh
Abstract
It is a challenging task to diagnose mycosis fungoides (MF), a type of primary cutaneous lymphoma, in the early stages of its development, due to the unspecific presentations associated with the disease. Histopathology and immunohistochemistry conduce to a more definite diagnosis. Presence of atypical ...
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It is a challenging task to diagnose mycosis fungoides (MF), a type of primary cutaneous lymphoma, in the early stages of its development, due to the unspecific presentations associated with the disease. Histopathology and immunohistochemistry conduce to a more definite diagnosis. Presence of atypical T-cells in epidermis and upper dermis is the most significant pathologic finding. Herein, we present an 80-year-old lady with unusual generalized lesions resembling prurigo nodularis for 3 years, who was finally diagnosed as a case of MF with eosinophilic infiltrations in her lesions and serum eosinophilia.
Rafiei Rana; Eftekhari Hojat; Granmayeh Siamak; Shafaei Sareh
Volume 19, Issue 3 , 2016, , Pages 97-100
Abstract
Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is histologically characterized by atypical T lymphocytes with cerebriform nuclei that infiltrate the epidermis. Alope
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Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is histologically characterized by atypical T lymphocytes with cerebriform nuclei that infiltrate the epidermis. Alope
Nahidi Yalda; Meibodi Naser Tayyebi; Ghazvini Kiarash; Esmaeeli Habiballah; Nahidi Mahsa
Volume 18, Issue 4 , 2015, , Pages 163-168
Abstract
Background: Mycosis fungoides is the most common type of primary cutaneous T-cell lymphoma. Its etiopathogenesis, despite numerous studies, remains unclear. Environmental, viral, and genetic factors have been proposed as its potential etiologic factors. In recent years, viral agents of herpes virus family ...
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Background: Mycosis fungoides is the most common type of primary cutaneous T-cell lymphoma. Its etiopathogenesis, despite numerous studies, remains unclear. Environmental, viral, and genetic factors have been proposed as its potential etiologic factors. In recent years, viral agents of herpes virus family such as human herpes virus 8 (HHV-8) have been noticed.Objective: The aim of this study was to evaluate the association between the presence of HHV-8 and mycosis fungoides.Methods: This case-control study was done on skin biopsies of 42 mycosis fungoides cases referred to the Department of Pathology, Imam Reza Hospital, Mashhad, Iran from 2004 to2012, and 42 age and sex matched samples of melanocytic nevi. PCR was performed to detect HHV-8 in biopsy samples of the patients and the control group. Statistical analysis was done using the IBM SPSS Statistics (IBM Corp., Armonk, NY, USA) 20.Results: Of 42 patients with MF, 25 were male and 17 were female with a male to female ratio of 1.4. The mean age of the patients was 51.2 years. Most of the patients were in the age group over 60 years. Clinical lesions of the majority of the patients were papules and plaques. HHV-8 DNA was not found in any of the mycosis fungoides samples using the PCR method.Conclusion: Based on our study results, HHV-8 does not play an important role in the pathogenesis of mycosis fungoides.
Azita Nikoo
Volume 14, Issue 3 , 2011, , Pages 100-105
Abstract
Background: Chemokines are a family of cytokines initially characterized by their capacity to induce chemotaxis, or directed leukocyte migrations. These receptors are activated by chemotactic cytokines called chemokines. Interactions between chemokines and chemokine receptors also are involved in tumorigenesis, ...
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Background: Chemokines are a family of cytokines initially characterized by their capacity to induce chemotaxis, or directed leukocyte migrations. These receptors are activated by chemotactic cytokines called chemokines. Interactions between chemokines and chemokine receptors also are involved in tumorigenesis, migration and invasion of lymphoma cells.Methods: An English literature search was performed using Medline (Through Pub med; from 1995 to 2011), with limiting factors of “chemokine” and “mycosis fungoides”. Peer-reviewed articles were selected for inclusion after excluding identical papers. After reviewing all the articles, a total of 34 papers about the role of chemokines in mycosis fungoides were selected to review.Results: The potential role of specific chemokine receptors and their chemokines, including CXCR3, CCR4, CCR10, and CCR7 in the pathophysiology of mycosis fungoides, and the role of chemokines in the treatment and outcome of mycosis fungoides were discussed.Conclusion: Knowing more about the mechanisms of chemokines/ chemokine receptors interaction and use of receptor antagonists or anti-receptor antibodies as therapeutic agents could be a new modality for treatment of cutaneous T cell lymphoma.
Hayedeh Ghani-Nejad; Mansour Nasiri-Kashani; Reza Mahmoud Robati; Pedram Mehryan; Alireza Alavi-nia; Soheil Fateh
Volume 10, Suppl.2 , 2007, , Pages 3-3
Abstract
Acquired ichthyosis is a known paraneoplastic sign of lymphoproliferative malignancies with nonspecific histopathologic findings revealing no implication of the underlying neoplasm. However, ichthyosiform eruption is considered as a specific manifestation of mycosis fungoides (MF), i.e., ichthyosiform ...
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Acquired ichthyosis is a known paraneoplastic sign of lymphoproliferative malignancies with nonspecific histopathologic findings revealing no implication of the underlying neoplasm. However, ichthyosiform eruption is considered as a specific manifestation of mycosis fungoides (MF), i.e., ichthyosiform MF. There are a few reports of ichthyotic manifestation of MF, but only one report of this presentation in Parapsoriasis. We present a case of ichthyosiform Parapsoriasis in a 22-year-old woman with hyperpigmented ichthyosiform scaly patches on her trunk and extremities. The histopathologic findings were hyperkeratosis, parakeratosis and acanthosis with scattered lymphocyte infiltration, also could be seen in Parapsoriasis. The patient responded well to oral photochemotherapy.
Pouran Layegh; Mohammad Reza Kalantari; Amir Omidvar-Borna; Yalda Nahidi
Volume 10, Suppl.2 , 2007, , Pages 10-10
Abstract
Mycosis fungoides is a common form of cutaneous T-cell lymphoma, with characteristic histopathology and chronic clinical course. Vesiculobullous mycosis fungoides is a rare occurrence. Here we present a 55-year-old man with multiple bullous plaques of one year duration who was finally diagnosed as a ...
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Mycosis fungoides is a common form of cutaneous T-cell lymphoma, with characteristic histopathology and chronic clinical course. Vesiculobullous mycosis fungoides is a rare occurrence. Here we present a 55-year-old man with multiple bullous plaques of one year duration who was finally diagnosed as a case of mycosis fungoides.
Kamran Balighi; Fatemeh Moeineddin; Ahmadreza Rajaee; Azita Nikoo; Mostafa Mahdavi-nia
Volume 10, Suppl.2 , 2007, , Pages 12-12
Abstract
Mycosis fungicides (MF), on extremely rare occasions, can be associated with vesiculobullous eruptions. We describe a 74-year-old man with previous documented histopathologic diagnosis of poikilodermic type of MF who recently developed some flaccid acral bullae on erythemoatous MF plaque and normal skin. ...
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Mycosis fungicides (MF), on extremely rare occasions, can be associated with vesiculobullous eruptions. We describe a 74-year-old man with previous documented histopathologic diagnosis of poikilodermic type of MF who recently developed some flaccid acral bullae on erythemoatous MF plaque and normal skin. Histopathology and direct immunoflourscence studies revealed extensive lichenoid changes with intraepidermal bulla. Atypical lymphocyte infiltration was presented in dermoepidermal junction and bulla fluid and peripheral blood smear, but absent in lymph node and bone narrow tissue specimens. The plausible cause of blister formation in cutaneous lymphoma bullosa may be due to excessive epidermotropism or toxic effects of cytokines secrected by the tumoral infiltrate.
H Seirafi; F Farnaghi; AR Firooz; S Mostafa; Y Sedaghat
Volume 8, Issue 5 , 2005, , Pages 347-352
AR Khooei; MR Keramat
Volume 8, Issue 3 , 2005, , Pages 201-210
Abstract
Background: Cutaneous lymphomas are monoclonal neoplastic proliferations of immune cells most frequently T or B cells that infiltrates skin. Development of new diagnostic methods, particularly those for immunophenotyping, have substantially changed classification of these neoplasms. These reasons prompted ...
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Background: Cutaneous lymphomas are monoclonal neoplastic proliferations of immune cells most frequently T or B cells that infiltrates skin. Development of new diagnostic methods, particularly those for immunophenotyping, have substantially changed classification of these neoplasms. These reasons prompted us to perform this study. Objective: To re-classify cutaneous lymphomas and pseudolymphomas in Mashhad. Patients and Methods: We reevaluated the specimens from a recent 10-year period filing in Imam Reza and Omid hospitals pathology archives and selected 46 cases diagnosed as any kind of skin lymphoid neoplasms. Then further histochemical and immunohistochemical staining were performed. Results: 43 cases of definitely diagnosed lymphohematopoietic cutaneous disorders were compared of 26 (60.5%) cutaneous T cell lymphoma (CTCL), 16 (14%) cutaneous B cell lymphoma, 7 (16.3%) pseudolymphoma and 1 (2.2%) case of Hodgkin’s disease (Secondary involvement). Conclusion: CTCLs were the most common lymphomas of the skin and mycosis fungoides was the most common CTCL. Immunohistochemical techniques can be greatly helpful in diagnosis and classification of cutaneous lymphomas. However, routine microscopic evaluation still remains the principle method for diagnosis, especially when there is a close cooperation between dermatologists and pathologists.
H Mortazavi; SN Emadi; F Farnaghi; H Seirafi; F Safar
Volume 7, Issue 3 , 2004, , Pages 171-178
Abstract
Immunosuppression is known to be associated with increased rate of malignancies and widespread dermatophytosis in the patients with sezary syndrome and this may account for the occurrence of Kaposi’s sarcoma and generalized dermatophytosis in patients in this report. Herein, we report a 58-year-old ...
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Immunosuppression is known to be associated with increased rate of malignancies and widespread dermatophytosis in the patients with sezary syndrome and this may account for the occurrence of Kaposi’s sarcoma and generalized dermatophytosis in patients in this report. Herein, we report a 58-year-old farmer man, who admitted with two months history of severely pruritic skin lesions, which progressed to erythroderma. Concurrently some vascular lesions were observed on glans penis off the patient suggestive of Kaposi’s sarcoma. Leukocytosis with eosinophilia (20%) and atypical lymphocytosis (More than 10%) were present. Microscopic examination of biopsy of erythrodermic skin lesions on trunk revealed pautrier micro abscess with dermal lymphocytic infiltration and cellular atypia, and the peripheral blood sample showing sezary cells and high ratio of CD4/CD8 (45) lymphocyte were in favor of diagnosis of sezary syndrome. The pathologic evaluation of the vascular lesion of glans penis proved the diagnosis of Kaposi’s sarcoma. During the progression of disease, the patient was invaded by generalized dermatophyte infection. KOH smear of annular skin lesion showed mycelia of dermatophyte and culture proved trichophyton rubrum to be the pathogenic agent.
M Shahidi Dadras; L Ataei
Volume 4, Issue 2 , 2001, , Pages 21-25
Abstract
Background: Mycosis fungoides (MF) is a cutaneous T cell lymphoma. There are only palliative treatments in advanced stages with no cure. Most chemotherapy regimens have temporary effects with various side effects. Objective: The objective of this study was to assess the efficacy of a new chemotherapy ...
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Background: Mycosis fungoides (MF) is a cutaneous T cell lymphoma. There are only palliative treatments in advanced stages with no cure. Most chemotherapy regimens have temporary effects with various side effects. Objective: The objective of this study was to assess the efficacy of a new chemotherapy regimens in advanced stages of MF. This regimens takes advantage of synergistic effect of methotrexate and fluorouracil and also uses leucovorin to reduce side effects of methotrexate. Patients and Methods: Five patients with advanced stages of MF (Stage IIB and higher) were treated with several courses of this chemotherapy regimens in a quasi experimental study. Results: Four patients responded partially one responded completely to this regimen but all of them relapsed after tapering the treatment. All of them tolerated the drugs well and no serious side effects were observed. Tumoral lesions showed better response. Conclusion: Although this chemotherapy regimen, similar to other regimens, only had temporary and palliative effects, it was tolerated well without serious side effects.
