Clinicopathological Evaluation and Outcome of Mycosis Fungoides

Abstract

Although mycosis fungoides is the most common cutaneous T-cell lymphoma, its etiopathogenesis has not been clarified definitively and there is no standard and curative treatment method. Medical records of 57 patients diagnosed with mycosis fungoides by clinical and histopathological findings were retrospectively reviewed in our clinic. Complete blood count, erythrocyte sedimentation rate, peripheral blood smear, biochemical findings, chest radiographs, and computerized tomography of all patients were reviewed; patients were staged using TNM system. The clinical presentation was classical patch/plaque form in 44patients and other forms in 13. According to TNM staging, 9patients were stage 1a, 38 were stage 1b, 5 were 2a, and 2 were stage 3, and 2 were stage 4a. The pathological findings were basal alignment of lymphocytes, reticular fibroplasia, atypical lymphocytes, and epidermotropism. Remission was achieved by topical imiquimod in 2patients, phototherapy in 30, and phototherapy and systemic treatment in 8. Remission rate with narrow band UV B was 72%, and that of psoralen UV A was 85.71%. Ten patients in remission had recurrence. Age, sex, duration of disease, and clinical presentation had no effect on remission or recurrence of mycosis fungoides. Reticular fibroplasia is a supporting histopathological finding in mycosis fungoides, together with basal alignment of lymphocytes, atypical lymphocytes and epidermotropism. Topical imiquimod treatment for local lesions and phototherapy for widespread lesions are effective, and psoralen UVA treatment seems to be more efficient than narrow band UVB.