Histologic criteria for the diagnosis of mycosis fungoides: proposal for a grading system to standardize pathology reporting

Abstract

The use of uniform criteria and training sessions can substantially improve the consensus rate among pathologists in the diagnosis of MF.

Revisions to the staging and classification of mycosis fungoides and Sézary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)

“…12 In some instances, the diagnosis of MF can be rendered with confidence on a skin biopsy specimen based on typical light microscopic changes, that is, marked epidermotropism of cytologically atypical T lymphocytes, clusters of these cells in the epidermis (Pautrier microabscesses), or a bandlike infiltrate containing abnormal lymphocytes in the upper dermis. [13][14][15][16] However, a definitive histopathologic diagnosis by light microscopy alone may be difficult to make in early MF 17,18 or in erythroderma in which inflammatory cells often predominate. 19 The ISCL recently proposed a diagnostic algorithm for early MF (Table 3).…”

Selected Inflammatory Imitators of Mycosis Fungoides: Histologic Features and Utility of Ancillary Studies

“…4,14 These difficulties are highlighted by reported false-negative and false-positive rates as high as 40%, 15 in addition to low concordance and reproducibility rates. 4,[8][9][10] Because of these diagnostic challenges in early MF, during the past decades, several authors have attempted to identify the most-reliable diagnostic criteria for distinguishing MF from benign dermatoses. 4,5,7,[10][11][12][13][14]16,17 Characteristic histopathologic features of early MF include the presence of enlarged epidermal lymphocytes with cerebriform nuclei within the epidermis and minimal associated spongiosis (epidermotropism), larger lymphocytes in the epidermis than in the dermis, lymphocytes with perinuclear clearing (halo), and a linear arrangement of basilar epidermal lymphocytes along the dermal-epidermal junction (tagging) (Figure 2, B through D).…”

“…4,[8][9][10] Because of these diagnostic challenges in early MF, during the past decades, several authors have attempted to identify the most-reliable diagnostic criteria for distinguishing MF from benign dermatoses. 4,5,7,[10][11][12][13][14]16,17 Characteristic histopathologic features of early MF include the presence of enlarged epidermal lymphocytes with cerebriform nuclei within the epidermis and minimal associated spongiosis (epidermotropism), larger lymphocytes in the epidermis than in the dermis, lymphocytes with perinuclear clearing (halo), and a linear arrangement of basilar epidermal lymphocytes along the dermal-epidermal junction (tagging) (Figure 2, B through D). * Some of the variable features that have been proposed as the most helpful in making a diagnosis of MF on multivariate analysis include strikingly irregular nuclear contours, 4 haloed lymphocytes, 7 cerebriform lymphocytes as large as a basal keratinocyte nucleus (ie, 7-9 lm), 17 and a linear arrangement of epidermal lymphocytes at the dermalepidermal junction.…”

“…4,[6][7][8][9][10][11] The histopathologic features of early MF vary from person to person, over time, and even between multiple sites in a single patient. 12,13 In addition, Figure 1.…”

Actualización en diagnóstico y manejo de micosis fungoide y síndrome de Sézary

“…Aunque se han propuesto criterios histopatológicos precisos para el diagnóstico de MF temprana, 43 en la mayoría de los casos el diagnóstico definitivo solo se logra con una cuidadosa correlación clínico-patológica.…”