Budair Fatimah M, Alsayyah Ahmed A, Alakloby Omar M
From the Department of Dermatology (Budair, Al-akloby) and from the Department of Pathology (Alsayyah), King Fahd University Hospital, Alkhobar, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Kingdom of Saudi Arabia.
Saudi Med J. 2024 Dec;45(12):1355-1367. doi: 10.15537/smj.2024.45.12.20240796.
To identify the clinical and histological features of MF that can assist in distinguishing MF from MF-mimicking cases. Although mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma, clinicopathological correlations are required to establish an accurate diagnosis, which are currently lacking.
This retrospective observational study evaluated the clinical presentations, characteristics, and histological features of 56 patients with suspected MF who presented to our clinic between January 2018 and August 2022. Immunohistochemistry was performed, and the loss of CD5 and CD7 T-cells and T-cell receptor rearrangement was evaluated.
Overall, 34 patients were diagnosed with MF, whereas 22 were not. Clinical erythroderma, poikiloderma, and nodular presentations were more commonly associated with a histological diagnosis of MF than macular presentations. Erythema and pruritus were significantly more common in MF cases than in MF-mimicking cases (<0.05). Epidermotropism and parakeratosis were the key histological features for diagnosing MF. Additionally, Pautrier's microabscesses correlated with the clinical presentation of plaques in MF. Loss of CD7 expression on the T-cell surface was observed even in early-stage MF cases.
Our proposed diagnostic features are statistically valid and, along with those previously reported, can aid in identifying and distinguishing MF cases from MF-mimicking cases.
确定蕈样肉芽肿（MF）的临床和组织学特征，以帮助将MF与类似MF的病例区分开来。尽管蕈样肉芽肿（MF）是皮肤T细胞淋巴瘤最常见的亚型，但目前仍缺乏建立准确诊断所需的临床病理相关性。
这项回顾性观察研究评估了2018年1月至2022年8月期间到我院就诊的56例疑似MF患者的临床表现、特征和组织学特征。进行了免疫组织化学检测，并评估了CD5和CD7 T细胞的缺失以及T细胞受体重排情况。
总体而言，34例患者被诊断为MF，而22例未被诊断为MF。与斑片状表现相比，临床红皮病、皮肤异色症和结节状表现更常与MF的组织学诊断相关。MF病例中的红斑和瘙痒比类似MF的病例明显更常见（<0.05）。向表皮性和角化不全是诊断MF的关键组织学特征。此外，Pautrier微脓肿与MF中斑块的临床表现相关。即使在MF早期病例中也观察到T细胞表面CD7表达缺失。
我们提出的诊断特征具有统计学有效性，并且与先前报道的特征一起，可有助于识别MF病例并将其与类似MF的病例区分开来。
