High‐frequency ultrasonography a new quantitative method in evaluation of skin lymphomas—First comparative study in relation to histopathology

Abstract

Introduction High‐frequency ultrasonography (HF‐USG) is a noninvasive method used in evaluation of depth and width of skin neoplasms. Recent data suggest that this method may also supplement objective clinical assessment in skin lymphomas, especially in mycosis fungoides, where subepidermal low echogenic band (SLEB) can be observed. The aim of the study was to present characteristic ultrasonic picture of MF in relation to histopathologic findings. Materials and methods Ten patients diagnosed as MF were included in the study. The USG examination was performed with the use of 20 MHz transducer within representative plaque. From the scanning lesion, the skin biopsy was taken. The relationship between histopathologic infiltrate with clonal T cells and USG image was investigated. Results In all analyzed sonograms obtained from lesional skin of early‐stage MF, we could detect the presence of subepidermal low echogenic band (SLEB). We detected strong correlations between SLEB thickness and the thickness of subepidermal infiltration (0.994, P < 0.05). Conclusions Subepidermal low echogenic band is a typical sign of infiltrative stage of MF, and its thickness may depend on the type of skin lesion. HF‐USG may be a reliable noninvasive method of quantitive assessments in MF, which corresponds to the thickness on T‐cell infiltration in histopathology.

Value of High‐Frequency Ultrasound in Accurate Staging of Mycosis Fungoides/Sézary Syndrome

“…The SLEB is not a specific US feature of an MF/SS diagnosis, so the diagnostic value of HF‐US is relatively restricted. Previous studies showed a significant correlation between the depth of atypical lymphocyte infiltration in histopathologic specimens and the thickness of the SLEB in early‐stage MF lesions . On this basis, our study also confirmed this conclusion with a larger sample size, including tumor stage lesions.…”

“…Based on previous reports, the following US features were adopted to evaluate MF: epidermal morphologic features (even or uneven), the infiltration depth (the deepest layer of the skin that the lesion infiltrated), the clarity of deep‐border boundaries (clearly or unclearly identified from the underlying skin structures), the homogeneity of internal echoes (homogeneous or inhomogeneous), posterior echoes (presence or absence of hypoechoic regions linearly distributed and perpendicular to the skin surface) and echogenic foci (presence or absence of pointlike hyperechoic structures <5 mm in diameter). To ensure that the lesion image was clear and completely displayed, we used 50‐MHz images whenever possible, especially when the lesions were in the early‐stage group, whereas 20‐MHz images were accepted when the lesions infiltrated into the deep dermis or subcutaneous tissue.…”

Intraoral Ultra‐High Frequency Ultrasound study of oral lichen planus: A pictorial review

“…Being a non‐invasive and repeatable technique, UHFUS could therefore integrate clinical examination and detect early changes in the epithelium, possibly leading to a redefinition of the indication to biopsy during follow‐up. Several studies describe the application of UHFUS for the study of various dermatological lesions, reporting strong correlation with histological data . Potentially, further studies comparing UHFUS aspect of OLP and histology could help validation of the technique.…”

“…Several studies describe the application of UHFUS for the study of various dermatological lesions, reporting strong correlation with histological data. 22,23 Potentially, further studies comparing UHFUS aspect of OLP and histology could help validation of the technique.…”

High-Frequency Ultrasonography in Dermatology

“…17). The thickness of subepidermal anechogenic or low echogenic band may correspond to the severity of the disease (correlation between clinical skin scores and subepidermal anechogenic or low echogenic band thickness has been obtained) and can be used to monitor the effects of therapies (Polańska et al 2017b(Polańska et al , 2019.…”