BACKGROUND Mycosis fungoides is the most common primary cutaneous T-cell lymphoma,whereas generalized erythroderma is rare.In this report,we describe a case of mycosis fungoides with generalized erythroderma using com...BACKGROUND Mycosis fungoides is the most common primary cutaneous T-cell lymphoma,whereas generalized erythroderma is rare.In this report,we describe a case of mycosis fungoides with generalized erythroderma using complete clinical data and[18F]fluoroDglucose positron emission tomography/computed tomography(18F-FDG PET/CT)images.CASE SUMMARY Systemic skin redness with desquamation for three years confirmed mycosis fungoides within one month.The patient underwent left axillary lymphadenectomy biopsy;pathological biopsy suggested abnormal T-cell lesions consistent with mycosis fungoides involving lymph nodes.The patient received methotrexate,5 mg twice weekly,as part of their chemotherapy regimen.Patients January half after discharge,no obvious cause of high fever,left axillary lymph nodes with red heat pain,and rupture entered our hospital for treatment.CONCLUSION The 18F-FDG PET/CT is essential for early diagnosis and timely treatment.展开更多
BACKGROUND Mycosis fungoides(MF)is a form of lymphoma derived from heterogeneous T cells,and eyelid involvement is extremely rare.The common methods to treat eyelid involvement are radiotherapy and chemotherapy,but th...BACKGROUND Mycosis fungoides(MF)is a form of lymphoma derived from heterogeneous T cells,and eyelid involvement is extremely rare.The common methods to treat eyelid involvement are radiotherapy and chemotherapy,but their efficacies are limited.Herein,we report a case of advanced-stage MF eyelid involvement,propose ultrasound(US)-guided microwave ablation(MWA)therapy and present a literature review.CASE SUMMARY A male patient was admitted to our hospital in June 2018 and diagnosed with MF via radiological and histopathological examinations.The patient’s condition was not well controlled by various conventional chemotherapies.US-guided MWA was performed to relieve the patient’s symptoms and improve his quality of life,showing satisfactory efficacy.CONCLUSION Eyelid involvement is one of the most troublesome clinical problems for advanced-stage MF patients.This is the first report on the use of US-guided MWA as a palliative therapy for MF eyelid involvement;the treatment successfully relieved the patient’s clinical symptoms and reduced his anxiety behaviours.Our study sheds new light on methods for improving the clinical management of eyelid involvement in MF.展开更多
Mycosis fungoides(MF),the most common type of cutaneous T-cell lymphoma,has various unspecific clinical and histological characteristics.Its early diagnosis is challenging.The application of T-cell receptor(TCR) gene ...Mycosis fungoides(MF),the most common type of cutaneous T-cell lymphoma,has various unspecific clinical and histological characteristics.Its early diagnosis is challenging.The application of T-cell receptor(TCR) gene clonal rearrangement to the diagnosis of MF has been widely studied.In this study,we used polymerase chain reaction(PCR) to investigate the diagnostic significance of detecting TCR-γ and-β gene clonal rearrangement in the early diagnosis of mycosis fungoides.PCR for TCR-γ and TCR-β gene rearrangement was performed on 19 patients with suspected early MF,6 with typical MF,and 6 with chronic dermatitis.Of the 19 patients with suspected early MF,13 had TCR-γ gene clonal rearrangement,whereas none had TCR-β gene clonal rearrangement.All patients with typical MF had TCR gene clonal rearrangement,in which 4 showed TCR-γ clonal rearrangement,1 showed TCR-β gene clonal rearrangements,and 1 showed both.No patients with chronic dermatitis had TCR gene clonal rearrangement.These results indicate that TCR gene clonal rearrangement analysis is a useful tool in diagnosing early MF.TCR-γ gene is recommended to the routine analysis,whereas TCR-β gene has potential in combination toward intractable cases.展开更多
Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides(MF).Methods From January 2008 to January 2013,a total of 11 patients with tumor-stage ...Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides(MF).Methods From January 2008 to January 2013,a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital.The median age of these patients was 53.36±14.45 years.Female-male ratio was 1:1.2.The average course of disease was 10.82±3.37 years.All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51(40-74) Gy in an average of 24.55±5.57(20-40) fractions,5 fractions per week.Results The median follow-up time was 55.27±29.3(13-103) months.No severe acute or chronic side effects of irradiation were observed.Complete clinical response(CR) rate of the radiated sites was 54.5%(6/11),partial response(PR) rate was 36.4%(4/11),and the overall response rate(CR+PR) was 90.9%.One patient showed no response.Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients.展开更多
Papular mycosis fungoides(MF) is a rare presentation of MF. Six illustrative cases of papular MF were retrospectively reviewed. Five of the cases studied by immunohistochemistry had variable numbers(range: 1%-20%) of ...Papular mycosis fungoides(MF) is a rare presentation of MF. Six illustrative cases of papular MF were retrospectively reviewed. Five of the cases studied by immunohistochemistry had variable numbers(range: 1%-20%) of CD30+ cells in the dermal infiltrate, a finding that is characteristic of lymphomatoid papulosis but may occasionally occur in typical early MF. Although none of our papular MF patients had progressive disease, lesions with relatively high numbers of CD30+ cells in 3 patients did not respond well to skin-directed treatments used for MF. Interestingly, these patients had evidence of coexisting clonal B cell populations in the blood(one with clonal B cell lymphocytosis and two with B-cell chronic lymphocytic leukemia). We conclude that:(1) papular MF may contain CD30+ cells, thereby causing confusion with lymphomatoid papulosis; and(2) papular MF, like more typical MF, may be associated with clonal B-cell proliferations including chronic lymphocytic leukemia.展开更多
Mycosis fungoides is a common cutaneous T-cell lymphoma,which is usually characterized by chronic,indolence progression,with absence of typical symptoms in early stage,metastasis to lymph nodes,bone marrow and viscera...Mycosis fungoides is a common cutaneous T-cell lymphoma,which is usually characterized by chronic,indolence progression,with absence of typical symptoms in early stage,metastasis to lymph nodes,bone marrow and visceral organs in later stage and ultimately progression to systemic lymphoma.It can result in secondary skin infection which is a frequent cause of death. At present,no curative therapy existed.Therapeutic purpose is to induce remission,reduce tumor burden and protect immune function of patients.A case of patient with advanced severe mycosis fungoides receiving CHOP plus interferon a -2a was reported here,with disease-free survival of 7 months and overall survival of over 17.0 months,and current status as well as developments of mycosis fungoides were briefly introduced.展开更多
Mycosis fungoides(MF) is a cutaneous T-cell lymphoma that can undergo local progression with possible systemic dissemination. We report a case of a patient affected by MF with a pancreatic mass that was a diagnostic c...Mycosis fungoides(MF) is a cutaneous T-cell lymphoma that can undergo local progression with possible systemic dissemination. We report a case of a patient affected by MF with a pancreatic mass that was a diagnostic challenge between primitive tumor and pancreatic metastasis from MF. Clinical setting findings and imaging studies raised the suspicion of a pancreatic primary neoplasm. A diagnostic clue was provided by the combined histomorphologic/immunohistochemical study of pancreatic and cutaneous biopsies, which revealed a pancreatic localization of MF. Considering the rarity of metastatic localization of MF to the pancreas, we next investigated whether chemokinechemokine receptor interactions could be involved in the phenomenon to provide new insight into the possible mechanisms underlying metastatic localization of MF to the pancreas. Histological analyses of archival pancreatic tissue demonstrated that glucagon-secreting cells of the pancreatic islets expressed the CCL27 chemokine, which may have attracted in our case metastatic MF cells expressing the complementary receptor CCR10.展开更多
Introduction: The mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas representing about 50% of all cutaneous lymphomas. Its pathogenesis remains poorly understood. Thus, its rising incidence rates ca...Introduction: The mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas representing about 50% of all cutaneous lymphomas. Its pathogenesis remains poorly understood. Thus, its rising incidence rates call for an explanation. Several environmental and occupational factors have been implicated in the pathogenesis of this disease. Objective: To determine the potential occupational factors correlated in the occurrence of MF. Methods: Case-control study was carried out at the teaching Hospital Farhat Hached of Sousse (Tunisia) to investigate associations of MF and occupational risk factors. A questionnaire on lifetime job history was administered to 24 cases and controls. Cases were patients with MF and whose diagnosis was suspected by a dermatologist and confirmed by pathological examination. Controls were patients consulting in the occupational medicine department and matched to cases by age and gender. Bivariate analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: The average age of onset of the disease was 55.41 ± 17.4 years with a sex ratio of 2.42. We found an increased risk of MF associated with tobacco consumption higher than 40 Pack-year (OR = 6.6;95% CI = 1.22 to 35.4), exercise in the textile sector (OR = 9.4;CI = 1.06 to 84.3) and exposure to diesel exhaust (OR = 9.47;95% CI = 1.06 to 84.3). Conclusion: Occupational factors could play a role in the pathogenesis of MF. Regarding our study, smoking, working in the textile industry and exposure to diesel exhaust appear to be involved in the pathogenesis of MF. Further investigation is needed to confirm these findings.展开更多
Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma accounting for approximately half of all cutaneous T-cell lymphomas. Radiation therapy is an effective treatment for early stage MF and has been show...Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma accounting for approximately half of all cutaneous T-cell lymphomas. Radiation therapy is an effective treatment for early stage MF and has been shown to result in long-term disease-free intervals, with even curative potential. Radiation is also effective as palliative treatment for the localized lesion resistant to the topic or other treatments. In the current study, we report using high dose rate (HDR) radiation treatment for a patient with resistant mycosis fungoides involving the wrist. We report a convenient treatment with an ideal radiation dose distribution, and a excellent clinical outcome.展开更多
Objectives. To detect telomerase activity in patients with mycosis fungoides (MF) and to study therole of telomerase in the tumorigenesis of MF.Methods. The technique of PCR-ELISA was employed to detect telomerase act...Objectives. To detect telomerase activity in patients with mycosis fungoides (MF) and to study therole of telomerase in the tumorigenesis of MF.Methods. The technique of PCR-ELISA was employed to detect telomerase activity in 35 patientswith various stages of MF.Results. 92.3% tumor stage of MF, 78.6% plaque stage of MF and 75.0% patch stage of MF hadpositive telomerase activity. The control samples had no telomerase activity. Telomerase activity in tumorstage of MF was significantly higher than that in plaque stage, while the latter was higher than that inpatch stage. Telomerase activity was correlated with the stage of MF.Conclusion. High level of telomerase activity frequently occurred in patients with MF, suggestingthat telomerase might play an important role in the tumorigenesis of MF and is a useful marker for thediagnosis of MF possibly.展开更多
Background: Mycosis fungoides (MF) is not an uncommon T-cell lymphoma in Iraqi population which is increasing over years. There are many diagnostic techniques to confirm the diagnosis including histopathological and i...Background: Mycosis fungoides (MF) is not an uncommon T-cell lymphoma in Iraqi population which is increasing over years. There are many diagnostic techniques to confirm the diagnosis including histopathological and immunohistochemical tests. Objectives: To evaluate all cases of MF including clinical, histopathological and immunohistochemical tests with CD markers. Patients and Methods: This clinical, histopathological, immunohistochemical outpatient based study took place in the Department of Dermatology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq during the period from May 2012-September 2013. Twenty five patients with MF were included in the present work. History was obtained from each patient regarding all socio-demographic aspects related to the disease. Also, clinical evaluation was carried out for all patients. Incisional biopsies for ordinary histopathology and immunohistochemical tests were done. Then staging was carried out depending on TNMB classification for all patients. Results: All cases of MF were confirmed after clinical evaluation, histopathology and immunohistochemical examination. Male to female ratio was 1.5:1. The mean age of onset at presentation was 47.45 ± 16.9 years. Itching was found in 84% of cases. The patch stage was seen in 36% patients. The hypopigmentaed MF was presented in 12% cases. The lower extremities were seen in 80%. Lymph node involvement as a manifestation of the disease was seen in 44% cases. The histopathological features of MF went parallel with the clinical stage of disease. Immunohistochemical study aids in the diagnosis of patch and erythrodermic stages. The most patients presented with stage IB (36%). Conclusion: MF seems to be not uncommon problem in Iraqi population and is increasing over years. The disease was diagnosed early commonly with patch stage (stage IB) while hypopigmented MF was not a common variant when compared with neighboring countries.展开更多
Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitat...Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitateother dermatoses, correct diagnosis may be a challenge both for clinicians as well as dermatopathologists. As a consequence, diagnosis of cutaneous lymphoma may be initially missed and, therefore, prompt and adequate therapeutic measures delayed. Hence, the purpose of our article was to give an overview of hitherto published "mimickers" of mycosis fungoides with a review of its diverse clinical features to alert the clinicians about the wide spectrum of this dissimulating disease. By integrating our own encountered atypical cases of mycosis fungoides we provide a comprehensive illustrated histological and moleculargenetic workup thereof and thereby critically revise the different available diagnostic tools of daily routine. Finally, we derive a practical algorithm to obtain the correct diagnosis even in such ambiguous cases of mycosis fungoides.展开更多
Mycosis fungoides is the most common form of cutaneous T-cell lymphoma(CTCL), and is characterized by a clonal expansion of malignant CD4+ T lymphocytes with skinhoming properties. Clinically and pathologically, mycos...Mycosis fungoides is the most common form of cutaneous T-cell lymphoma(CTCL), and is characterized by a clonal expansion of malignant CD4+ T lymphocytes with skinhoming properties. Clinically and pathologically, mycosis fungoides can be categorized into patch, plaque and tumor stages. The clinical course of mycosis fungoides is usually chronic and indolent, but a proportion of patients may develop progressive disease with peripheral blood, lymph node and visceral organ involvement. Sézarysyndrome is an aggressive leukemic form of CTCL characterized by a clonal population of malignant T cells in the peripheral blood. Various forms of skin-directed and systemic treatments are available for mycosis fungoides and Sézary syndrome. However, current treatments are generally not curative, and can only control the disease. Currently, the etiology and pathogenesis of mycosis fungoides and Sézary syndrome are not well defined. Proposed mechanisms include chronic antigenic stimulation by infectious agents, expression of specific adhesion molecules, altered cytokine production, mutations of oncogenes and tumor suppressor genes, and avoidance of apoptosis. In recent years, a number of chemokine receptors and their corresponding chemokine ligands have been found to contribute to the migration and survival of lymphoma cells in mycosis fungoides and Sézary syndrome, including CC chemokine receptor 4(CCR4), CCR10, C-X-C chemokine receptor type 4(CXCR4), CCR7, CCR3 and CXCR3. Since chemokines and chemokine receptors have been found to play important roles in the pathophysiology of mycosis fungoides and Sézary syndrome, they may be potentially useful targets for the development of new treatments for these diseases in the future.展开更多
Mycosis fungoides and Sèzary syndrome are the most common subtypes of cutaneous T-cell lymphomas. Even though, in early-stage disease, Mycosis fungoides commonly has a more indolent course, disease will progress ...Mycosis fungoides and Sèzary syndrome are the most common subtypes of cutaneous T-cell lymphomas. Even though, in early-stage disease, Mycosis fungoides commonly has a more indolent course, disease will progress in about 20% of such patients. About 30% of patients have been reported to develop advancedstage disease and, at present, there is no cure for the disease. A number of systemic approaches have been used for advanced-stage mycosis fungoides(IIB-IV) and transformed disease. Aggressive approaches seem to be warranted in such patients. The scope of this review is the stem cell transplantation in mycosis fungoides and its leukemic variant, Sèzary syndrome.展开更多
Background: Mycosis Fungoides (MF) is the most common and indolent form of Cutaneuse T-cell Lymphomas (CTCL), that usually occurs in old adults. Objectives: To determine epidemiologic features and patients characteris...Background: Mycosis Fungoides (MF) is the most common and indolent form of Cutaneuse T-cell Lymphomas (CTCL), that usually occurs in old adults. Objectives: To determine epidemiologic features and patients characteristics of MF in Isfahan (Iran). Methods: We performed a retrospective study in MF clinic of alzahra hospital that is the main center for treatment of MF patients in Isfahan (Iran) and evaluated clinicopathologic features. Results: In 3 years 25 patients were referred to Alzahra MF clinic. 18 patients diagnosed as MF. Seven (38.9%) patients were male and 11 (61.1%) were female with male to female ratio of 1:1.57. The mean age of patients was 41.06 years. 88.9% of our patients were in stages ΙA and ΙB. Conclusion: Most of our patients presented in early stages that were similar to other studies, while male: female ratio is different from other studies.展开更多
Hypopigmented mycosis fungoides (HMF) is an uncommon variant of cutaneous T-cell lymphoma. It is more frequent in dark-skinned people, particularly children. The HMF diagnose is difficult, especially in early stages b...Hypopigmented mycosis fungoides (HMF) is an uncommon variant of cutaneous T-cell lymphoma. It is more frequent in dark-skinned people, particularly children. The HMF diagnose is difficult, especially in early stages because this condition resembles benign skin diseases. Thus is histopathological analysis very important for the diagnosis. We report a case of a 7-year-old child with widespread HMF confirmed by histopathology that showed cells tagging along the dermal/epidermal junction and extending into the epidermis in a pattern of epidermotropism and focal cell aggregates in the epidermis (Pautrier’s microabscess). We demonstrate the importance of clinical suspicion for this cutaneous neoplasia in patients with hypopigmentated lesions.展开更多
An 86-year-old man, diagnosed as having mycosis fungoides in May 2008 and treated with repeated radiation therapy, was admitted to our hospital for initiation of hemodialysis due to end-stage renal disease(ESRD) in Ap...An 86-year-old man, diagnosed as having mycosis fungoides in May 2008 and treated with repeated radiation therapy, was admitted to our hospital for initiation of hemodialysis due to end-stage renal disease(ESRD) in April 2012. On admission, his corrected serum calcium level was 9.3 mg/d L, and his intact parathyroid hormone level was 121.9 pg/mL(normal range 13.9-78.5pg/mL), indicating secondary hyperparathyroidism due to ESRD. After starting hemodialysis, urinary volume diminished rapidly. The serum calcium level increased(12.7 mg/dL), and the intact parathyroid hormone level was suppressed(< 5 pg/m L), while the 1,25-dihy-droxyvitamin D3(calcitriol) level increased(114 pg/mL, normal range: 20.0-60.0 pg/m L) in June 2012. The possibilities of sarcoidosis and tuberculosis were ruled out. Skin biopsies from tumorous lesions revealed a diagnosis of granulomatous mycosis fungoides. The serum soluble interleukin-2 receptor levels and the degrees of skin lesions went in parallel with the increased serum calcium and calcitriol levels. Therefore, the patient was diagnosed as having calcitriol-induced hypercalcemia possibly associated with granulomatous mycosis fungoides. Granulomatous mycosis fungoides is rare, and its association with calcitriol-induced hypercalcemia has not been reported. Careful attention to calcium metabolism is needed in patients with granulomatous mycosis fungoides, especially in patients with ESRD.展开更多
Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompete...Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.展开更多
Introduction Mycosis fungoides (MF) is the most common form of cutaneous lymphoma,accounting for almost 50% of all types.1 MF occasionally manifests as the interstitial lymphocytic infiltrate that mimics inflammatory ...Introduction Mycosis fungoides (MF) is the most common form of cutaneous lymphoma,accounting for almost 50% of all types.1 MF occasionally manifests as the interstitial lymphocytic infiltrate that mimics inflammatory morphea,interstitial granulomatous dermatitis,and interstitial granuloma annulare,and this rare histopathological variant has been termed interstitial mycosis fungoides (IMF).IMF can be considered as a transient histopathological pattern in conventional MF,with common clinical presentation as patches and plaques.展开更多
文摘BACKGROUND Mycosis fungoides is the most common primary cutaneous T-cell lymphoma,whereas generalized erythroderma is rare.In this report,we describe a case of mycosis fungoides with generalized erythroderma using complete clinical data and[18F]fluoroDglucose positron emission tomography/computed tomography(18F-FDG PET/CT)images.CASE SUMMARY Systemic skin redness with desquamation for three years confirmed mycosis fungoides within one month.The patient underwent left axillary lymphadenectomy biopsy;pathological biopsy suggested abnormal T-cell lesions consistent with mycosis fungoides involving lymph nodes.The patient received methotrexate,5 mg twice weekly,as part of their chemotherapy regimen.Patients January half after discharge,no obvious cause of high fever,left axillary lymph nodes with red heat pain,and rupture entered our hospital for treatment.CONCLUSION The 18F-FDG PET/CT is essential for early diagnosis and timely treatment.
基金Supported by Zhenjiang Social Development Fund,No.SH2021028Zhenjiang Social Development Fund,No.SH2018035the“169”Project of Zhenjiang City,No.YLJ201931.
文摘BACKGROUND Mycosis fungoides(MF)is a form of lymphoma derived from heterogeneous T cells,and eyelid involvement is extremely rare.The common methods to treat eyelid involvement are radiotherapy and chemotherapy,but their efficacies are limited.Herein,we report a case of advanced-stage MF eyelid involvement,propose ultrasound(US)-guided microwave ablation(MWA)therapy and present a literature review.CASE SUMMARY A male patient was admitted to our hospital in June 2018 and diagnosed with MF via radiological and histopathological examinations.The patient’s condition was not well controlled by various conventional chemotherapies.US-guided MWA was performed to relieve the patient’s symptoms and improve his quality of life,showing satisfactory efficacy.CONCLUSION Eyelid involvement is one of the most troublesome clinical problems for advanced-stage MF patients.This is the first report on the use of US-guided MWA as a palliative therapy for MF eyelid involvement;the treatment successfully relieved the patient’s clinical symptoms and reduced his anxiety behaviours.Our study sheds new light on methods for improving the clinical management of eyelid involvement in MF.
基金supported by grant from Sichuan Provincial Sci-Tech Research Foundation (No.07SG004009)
文摘Mycosis fungoides(MF),the most common type of cutaneous T-cell lymphoma,has various unspecific clinical and histological characteristics.Its early diagnosis is challenging.The application of T-cell receptor(TCR) gene clonal rearrangement to the diagnosis of MF has been widely studied.In this study,we used polymerase chain reaction(PCR) to investigate the diagnostic significance of detecting TCR-γ and-β gene clonal rearrangement in the early diagnosis of mycosis fungoides.PCR for TCR-γ and TCR-β gene rearrangement was performed on 19 patients with suspected early MF,6 with typical MF,and 6 with chronic dermatitis.Of the 19 patients with suspected early MF,13 had TCR-γ gene clonal rearrangement,whereas none had TCR-β gene clonal rearrangement.All patients with typical MF had TCR gene clonal rearrangement,in which 4 showed TCR-γ clonal rearrangement,1 showed TCR-β gene clonal rearrangements,and 1 showed both.No patients with chronic dermatitis had TCR gene clonal rearrangement.These results indicate that TCR gene clonal rearrangement analysis is a useful tool in diagnosing early MF.TCR-γ gene is recommended to the routine analysis,whereas TCR-β gene has potential in combination toward intractable cases.
文摘Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides(MF).Methods From January 2008 to January 2013,a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital.The median age of these patients was 53.36±14.45 years.Female-male ratio was 1:1.2.The average course of disease was 10.82±3.37 years.All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51(40-74) Gy in an average of 24.55±5.57(20-40) fractions,5 fractions per week.Results The median follow-up time was 55.27±29.3(13-103) months.No severe acute or chronic side effects of irradiation were observed.Complete clinical response(CR) rate of the radiated sites was 54.5%(6/11),partial response(PR) rate was 36.4%(4/11),and the overall response rate(CR+PR) was 90.9%.One patient showed no response.Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients.
文摘Papular mycosis fungoides(MF) is a rare presentation of MF. Six illustrative cases of papular MF were retrospectively reviewed. Five of the cases studied by immunohistochemistry had variable numbers(range: 1%-20%) of CD30+ cells in the dermal infiltrate, a finding that is characteristic of lymphomatoid papulosis but may occasionally occur in typical early MF. Although none of our papular MF patients had progressive disease, lesions with relatively high numbers of CD30+ cells in 3 patients did not respond well to skin-directed treatments used for MF. Interestingly, these patients had evidence of coexisting clonal B cell populations in the blood(one with clonal B cell lymphocytosis and two with B-cell chronic lymphocytic leukemia). We conclude that:(1) papular MF may contain CD30+ cells, thereby causing confusion with lymphomatoid papulosis; and(2) papular MF, like more typical MF, may be associated with clonal B-cell proliferations including chronic lymphocytic leukemia.
基金supported by the Jiangsu province Natural Science Foundation of China(No.BK2010579)
文摘Mycosis fungoides is a common cutaneous T-cell lymphoma,which is usually characterized by chronic,indolence progression,with absence of typical symptoms in early stage,metastasis to lymph nodes,bone marrow and visceral organs in later stage and ultimately progression to systemic lymphoma.It can result in secondary skin infection which is a frequent cause of death. At present,no curative therapy existed.Therapeutic purpose is to induce remission,reduce tumor burden and protect immune function of patients.A case of patient with advanced severe mycosis fungoides receiving CHOP plus interferon a -2a was reported here,with disease-free survival of 7 months and overall survival of over 17.0 months,and current status as well as developments of mycosis fungoides were briefly introduced.
基金Supported by Cinque per mille e Ricerca Corrente,Ministero della Salute to Istituto Giannina Gaslini
文摘Mycosis fungoides(MF) is a cutaneous T-cell lymphoma that can undergo local progression with possible systemic dissemination. We report a case of a patient affected by MF with a pancreatic mass that was a diagnostic challenge between primitive tumor and pancreatic metastasis from MF. Clinical setting findings and imaging studies raised the suspicion of a pancreatic primary neoplasm. A diagnostic clue was provided by the combined histomorphologic/immunohistochemical study of pancreatic and cutaneous biopsies, which revealed a pancreatic localization of MF. Considering the rarity of metastatic localization of MF to the pancreas, we next investigated whether chemokinechemokine receptor interactions could be involved in the phenomenon to provide new insight into the possible mechanisms underlying metastatic localization of MF to the pancreas. Histological analyses of archival pancreatic tissue demonstrated that glucagon-secreting cells of the pancreatic islets expressed the CCL27 chemokine, which may have attracted in our case metastatic MF cells expressing the complementary receptor CCR10.
文摘Introduction: The mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas representing about 50% of all cutaneous lymphomas. Its pathogenesis remains poorly understood. Thus, its rising incidence rates call for an explanation. Several environmental and occupational factors have been implicated in the pathogenesis of this disease. Objective: To determine the potential occupational factors correlated in the occurrence of MF. Methods: Case-control study was carried out at the teaching Hospital Farhat Hached of Sousse (Tunisia) to investigate associations of MF and occupational risk factors. A questionnaire on lifetime job history was administered to 24 cases and controls. Cases were patients with MF and whose diagnosis was suspected by a dermatologist and confirmed by pathological examination. Controls were patients consulting in the occupational medicine department and matched to cases by age and gender. Bivariate analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: The average age of onset of the disease was 55.41 ± 17.4 years with a sex ratio of 2.42. We found an increased risk of MF associated with tobacco consumption higher than 40 Pack-year (OR = 6.6;95% CI = 1.22 to 35.4), exercise in the textile sector (OR = 9.4;CI = 1.06 to 84.3) and exposure to diesel exhaust (OR = 9.47;95% CI = 1.06 to 84.3). Conclusion: Occupational factors could play a role in the pathogenesis of MF. Regarding our study, smoking, working in the textile industry and exposure to diesel exhaust appear to be involved in the pathogenesis of MF. Further investigation is needed to confirm these findings.
文摘Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma accounting for approximately half of all cutaneous T-cell lymphomas. Radiation therapy is an effective treatment for early stage MF and has been shown to result in long-term disease-free intervals, with even curative potential. Radiation is also effective as palliative treatment for the localized lesion resistant to the topic or other treatments. In the current study, we report using high dose rate (HDR) radiation treatment for a patient with resistant mycosis fungoides involving the wrist. We report a convenient treatment with an ideal radiation dose distribution, and a excellent clinical outcome.
文摘Objectives. To detect telomerase activity in patients with mycosis fungoides (MF) and to study therole of telomerase in the tumorigenesis of MF.Methods. The technique of PCR-ELISA was employed to detect telomerase activity in 35 patientswith various stages of MF.Results. 92.3% tumor stage of MF, 78.6% plaque stage of MF and 75.0% patch stage of MF hadpositive telomerase activity. The control samples had no telomerase activity. Telomerase activity in tumorstage of MF was significantly higher than that in plaque stage, while the latter was higher than that inpatch stage. Telomerase activity was correlated with the stage of MF.Conclusion. High level of telomerase activity frequently occurred in patients with MF, suggestingthat telomerase might play an important role in the tumorigenesis of MF and is a useful marker for thediagnosis of MF possibly.
文摘Background: Mycosis fungoides (MF) is not an uncommon T-cell lymphoma in Iraqi population which is increasing over years. There are many diagnostic techniques to confirm the diagnosis including histopathological and immunohistochemical tests. Objectives: To evaluate all cases of MF including clinical, histopathological and immunohistochemical tests with CD markers. Patients and Methods: This clinical, histopathological, immunohistochemical outpatient based study took place in the Department of Dermatology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq during the period from May 2012-September 2013. Twenty five patients with MF were included in the present work. History was obtained from each patient regarding all socio-demographic aspects related to the disease. Also, clinical evaluation was carried out for all patients. Incisional biopsies for ordinary histopathology and immunohistochemical tests were done. Then staging was carried out depending on TNMB classification for all patients. Results: All cases of MF were confirmed after clinical evaluation, histopathology and immunohistochemical examination. Male to female ratio was 1.5:1. The mean age of onset at presentation was 47.45 ± 16.9 years. Itching was found in 84% of cases. The patch stage was seen in 36% patients. The hypopigmentaed MF was presented in 12% cases. The lower extremities were seen in 80%. Lymph node involvement as a manifestation of the disease was seen in 44% cases. The histopathological features of MF went parallel with the clinical stage of disease. Immunohistochemical study aids in the diagnosis of patch and erythrodermic stages. The most patients presented with stage IB (36%). Conclusion: MF seems to be not uncommon problem in Iraqi population and is increasing over years. The disease was diagnosed early commonly with patch stage (stage IB) while hypopigmented MF was not a common variant when compared with neighboring countries.
文摘Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitateother dermatoses, correct diagnosis may be a challenge both for clinicians as well as dermatopathologists. As a consequence, diagnosis of cutaneous lymphoma may be initially missed and, therefore, prompt and adequate therapeutic measures delayed. Hence, the purpose of our article was to give an overview of hitherto published "mimickers" of mycosis fungoides with a review of its diverse clinical features to alert the clinicians about the wide spectrum of this dissimulating disease. By integrating our own encountered atypical cases of mycosis fungoides we provide a comprehensive illustrated histological and moleculargenetic workup thereof and thereby critically revise the different available diagnostic tools of daily routine. Finally, we derive a practical algorithm to obtain the correct diagnosis even in such ambiguous cases of mycosis fungoides.
文摘Mycosis fungoides is the most common form of cutaneous T-cell lymphoma(CTCL), and is characterized by a clonal expansion of malignant CD4+ T lymphocytes with skinhoming properties. Clinically and pathologically, mycosis fungoides can be categorized into patch, plaque and tumor stages. The clinical course of mycosis fungoides is usually chronic and indolent, but a proportion of patients may develop progressive disease with peripheral blood, lymph node and visceral organ involvement. Sézarysyndrome is an aggressive leukemic form of CTCL characterized by a clonal population of malignant T cells in the peripheral blood. Various forms of skin-directed and systemic treatments are available for mycosis fungoides and Sézary syndrome. However, current treatments are generally not curative, and can only control the disease. Currently, the etiology and pathogenesis of mycosis fungoides and Sézary syndrome are not well defined. Proposed mechanisms include chronic antigenic stimulation by infectious agents, expression of specific adhesion molecules, altered cytokine production, mutations of oncogenes and tumor suppressor genes, and avoidance of apoptosis. In recent years, a number of chemokine receptors and their corresponding chemokine ligands have been found to contribute to the migration and survival of lymphoma cells in mycosis fungoides and Sézary syndrome, including CC chemokine receptor 4(CCR4), CCR10, C-X-C chemokine receptor type 4(CXCR4), CCR7, CCR3 and CXCR3. Since chemokines and chemokine receptors have been found to play important roles in the pathophysiology of mycosis fungoides and Sézary syndrome, they may be potentially useful targets for the development of new treatments for these diseases in the future.
文摘Mycosis fungoides and Sèzary syndrome are the most common subtypes of cutaneous T-cell lymphomas. Even though, in early-stage disease, Mycosis fungoides commonly has a more indolent course, disease will progress in about 20% of such patients. About 30% of patients have been reported to develop advancedstage disease and, at present, there is no cure for the disease. A number of systemic approaches have been used for advanced-stage mycosis fungoides(IIB-IV) and transformed disease. Aggressive approaches seem to be warranted in such patients. The scope of this review is the stem cell transplantation in mycosis fungoides and its leukemic variant, Sèzary syndrome.
文摘Background: Mycosis Fungoides (MF) is the most common and indolent form of Cutaneuse T-cell Lymphomas (CTCL), that usually occurs in old adults. Objectives: To determine epidemiologic features and patients characteristics of MF in Isfahan (Iran). Methods: We performed a retrospective study in MF clinic of alzahra hospital that is the main center for treatment of MF patients in Isfahan (Iran) and evaluated clinicopathologic features. Results: In 3 years 25 patients were referred to Alzahra MF clinic. 18 patients diagnosed as MF. Seven (38.9%) patients were male and 11 (61.1%) were female with male to female ratio of 1:1.57. The mean age of patients was 41.06 years. 88.9% of our patients were in stages ΙA and ΙB. Conclusion: Most of our patients presented in early stages that were similar to other studies, while male: female ratio is different from other studies.
文摘Hypopigmented mycosis fungoides (HMF) is an uncommon variant of cutaneous T-cell lymphoma. It is more frequent in dark-skinned people, particularly children. The HMF diagnose is difficult, especially in early stages because this condition resembles benign skin diseases. Thus is histopathological analysis very important for the diagnosis. We report a case of a 7-year-old child with widespread HMF confirmed by histopathology that showed cells tagging along the dermal/epidermal junction and extending into the epidermis in a pattern of epidermotropism and focal cell aggregates in the epidermis (Pautrier’s microabscess). We demonstrate the importance of clinical suspicion for this cutaneous neoplasia in patients with hypopigmentated lesions.
文摘An 86-year-old man, diagnosed as having mycosis fungoides in May 2008 and treated with repeated radiation therapy, was admitted to our hospital for initiation of hemodialysis due to end-stage renal disease(ESRD) in April 2012. On admission, his corrected serum calcium level was 9.3 mg/d L, and his intact parathyroid hormone level was 121.9 pg/mL(normal range 13.9-78.5pg/mL), indicating secondary hyperparathyroidism due to ESRD. After starting hemodialysis, urinary volume diminished rapidly. The serum calcium level increased(12.7 mg/dL), and the intact parathyroid hormone level was suppressed(< 5 pg/m L), while the 1,25-dihy-droxyvitamin D3(calcitriol) level increased(114 pg/mL, normal range: 20.0-60.0 pg/m L) in June 2012. The possibilities of sarcoidosis and tuberculosis were ruled out. Skin biopsies from tumorous lesions revealed a diagnosis of granulomatous mycosis fungoides. The serum soluble interleukin-2 receptor levels and the degrees of skin lesions went in parallel with the increased serum calcium and calcitriol levels. Therefore, the patient was diagnosed as having calcitriol-induced hypercalcemia possibly associated with granulomatous mycosis fungoides. Granulomatous mycosis fungoides is rare, and its association with calcitriol-induced hypercalcemia has not been reported. Careful attention to calcium metabolism is needed in patients with granulomatous mycosis fungoides, especially in patients with ESRD.
文摘Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.
基金supported by CAMS Innovation Fund for Medical Sciences (No. CIFMS-2017-I2M-1-107)
文摘Introduction Mycosis fungoides (MF) is the most common form of cutaneous lymphoma,accounting for almost 50% of all types.1 MF occasionally manifests as the interstitial lymphocytic infiltrate that mimics inflammatory morphea,interstitial granulomatous dermatitis,and interstitial granuloma annulare,and this rare histopathological variant has been termed interstitial mycosis fungoides (IMF).IMF can be considered as a transient histopathological pattern in conventional MF,with common clinical presentation as patches and plaques.
