Should patients with early mycosis fungoides, a skin cancer of immune cells, undergo imaging to detect lymph node involvement?

Abstract

Mycosis fungoides (MF) is a form of lymphoma, a cancer of immune cells called lymphocytes. In the early stages of MF only the skin is involved in the form of patches or plaques. In the later stages the skin is characterized by the appearance of nodules or generalized skin involvement, and the lymphoma may spread beyond the skin to involve primarily lymph nodes (glands) that become enlarged. In order to accurately assess the size and the structure of the lymph nodes imaging is needed. Because of the rarity of involvement of lymph nodes in patients with MF who have patches or plaques, current guidelines differ about the need to perform imaging at this early stage. In daily practice, there are physicians who recommend imaging in patch‐plaque MF only in the presence of enlarged lymph nodes on clinical examination. Policies vary between countries and between centres.