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Mycosis fungoides with spongiosis: A potential diagnostic pitfall.
- Source :
-
Journal of cutaneous pathology [J Cutan Pathol] 2019 Sep; Vol. 46 (9), pp. 645-652. Date of Electronic Publication: 2019 May 10. - Publication Year :
- 2019
-
Abstract
- Background: Mycosis fungoides (MF) is characterized by epidermotropic atypical lymphocytes in the absence of spongiosis. However, we describe an unusual presentation of MF with spongiosis, mimicking benign inflammatory dermatoses and highlight the importance of pathologic interpretation for diagnostic confirmation.<br />Methods: A cross-sectional study of consecutive patients diagnosed with MF with spongiosis was conducted. The clinical, histopathologic, immunophenotypic, and molecular genetic features of cases were reviewed.<br />Results: We identified nine cases of MF (age range 34-82 years; mean 75 years), with an initial diagnosis of dermatitis (6/9), psoriasis (4/9), or other inflammatory dermatoses (2/9). Pruritus, pain, and blisters were common clinical manifestations. The most common areas of involvement were the extremities (8/9). Epidermotropism with spongiosis was a central histopathological feature in all cases.<br />Conclusion: These cases highlight prominent spongiosis in MF and overlap with common benign inflammatory dermatoses. We present these cases to show the diagnostic pitfalls associated with spongiotic presentations of MF. Dermatitis, psoriasis, and other inflammatory skin conditions not responsive to standard therapy warrant further work-up including biopsy to rule out MF. Multiple skin biopsies and review by a dermatopathologist with expertise in the diagnosis of cutaneous lymphoma is highly recommended.<br /> (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Biopsy
Cross-Sectional Studies
Diagnosis, Differential
Female
Humans
Immunophenotyping
Male
Middle Aged
Retrospective Studies
Dermatitis diagnosis
Dermatitis metabolism
Dermatitis pathology
Mycosis Fungoides diagnosis
Mycosis Fungoides metabolism
Mycosis Fungoides pathology
Psoriasis diagnosis
Psoriasis metabolism
Psoriasis pathology
Skin Neoplasms diagnosis
Skin Neoplasms metabolism
Skin Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0560
- Volume :
- 46
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of cutaneous pathology
- Publication Type :
- Academic Journal
- Accession number :
- 30989664
- Full Text :
- https://doi.org/10.1111/cup.13477