Mycosis Fungoides

Question 1

most common cutaneous lymphoma

Answer 1

Mycosis fungoides

Question 2

3 stages

Answer 2

patch, plaque, or tumor stage

Question 3

Histology.

Answer 3

epidermotropism of Tcells with hyperconvoluted nuclei.

In the tumor stage, dermal
nodularin ltrates.

Question 4

Median age onset

Gender

Answer 4

Median age at diagnosis 55to 60 years.

Male 2:1

Question 5

Etiology.

Answer 5

a malignancy of skin-homing CTLA CD4 T cells

Question 6

Extensive tumor nodules can form what facie?

Answer 6

Leonine facies

Question 7

Dermatopathology.

Answer 7

Bandlike and patchy
infiltrate in upper dermis of atypical lymphocytes (mycosis cells) extending to epidermis and skin appendages.
The classic finding is the epidermotropism of this cell infiltrate, which will form microabscesses in the epidermis (Pautrier microabscesses).
Fibroplasia of the upper dermis.

Question 8

Hematology findings

Answer 8

Eosinophilia, 6 to 12%, can increase to 50%.
Buffycoat:Abnormal circulating cells (mycosis cell-type)
increased WBC(20,000/μL)
Bone marrow not of use in early stage

Question 9

(4) instances where prognosis is much worse

Answer 9

tumors are present (mean survival, 2.5 years),

2) there is lymphadenopathy (mean survival, 3 years)
(3) >10% of the skin surface is involved with pretumor-stage MF,
(4) there is a generalized erythroderma.

Patients < 50 years have twice the survival rate of patients>60years

Question 10

Treatment

Answer 10

PUVA

UVB