Morphometrical analysis of mycosis fungoides on paraffin‐embedded sections^*

Abstract

Morphometry was carried out on H&E stained paraffin sections of 29 cases of contact dermatitis (CD) and 35 cases of mycosis fungoides (MF) (patch stage 12; plaque stage 11; tumor stage 12); 9 nuclear parameters, mean thickness of the infiltrate and 5 stereological parameters were assessed for each slide. Application of a non-parametric discriminant analysis (k-nearest neighbour method) which is based on median of nuclear areas, mean maximal nuclear diameter, volume density and numerical density of nuclei provided discrimination between CD and patch stage MF at an efficiency of 82.9% (specifity 86.7%, sensitivity 61.5%). Efficiency of discrimination between CD and plaque stage was 92.5% (specifity 89.7%, sensitivity 91.7%) and between CD and tumor stage 100% when discriminant analysis was based on the mean thickness of the infiltrate. Although unequivocal discrimination between CD and MF cannot be achieved in each individual case, morphometry on routine paraffin material obviously provides additional objective criteria for the diagnosis of early MF.

Diagnostic value of combining immunostaining for CD3 and nuclear morphometry in mycosis fungoides

“…In our study this was the most important discriminating parameter, with 99.08% specificity and 99.54% sensitivity. Maximum diameter was also significantly different between benign dermatosis and MF (median 4.98 μm versus 6.54 μm), supporting the findings by Riegger et al and Santucci et al 17 27…”

“…The usefulness of determining the nuclear area of lymphocytes was subsequently shown by Lessana-Leibowitch et al ,4 using ultra-thin sections of epoxy embedded tissue, and by Sinha et al and Riegger et al using paraffin embedded specimens 17 26. In our study this was the most important discriminating parameter, with 99.08% specificity and 99.54% sensitivity.…”

“…This is especially true in cases with overlapping profiles, as in some instances CD7 may be expressed by neoplastic cells of MF in high numbers or it may be poorly expressed in benign dermatoses 15. Despite the need for more accurate morphometric methods which could add relevant information in decision making, a practical approach has not yet been widely developed 4 17…”

Application of stereology to dermatological research

“…A number of studies have focused on quantifying various cellular characteristics of mycosis fungoides (66,67). In one such study, a positive correlation between higher values of V v of mycosis cell nuclei at time of diagnosis and shorter survival has been established, but it was not possible to discriminate between plaque stage and tumor stage of the disease based on V v measurements (68).…”

Image analysis in dermatopathology

“…It was also used, less successfully, for distinguishing keratoacanthoma from squamous cell carcinoma (119) and Bowen's disease from bowenoid papulosis (120). Nuclear morphometry and stereology distinguished contact dermatitis and mycosis fungoides with 73% accuracy (121). Applying image analysis to sections immunostained with a panel of monoclonal antibodies, high grade lymphomas were found to differ from inflammatory lesions in the distribution of lymphocyte subpopulations (122).…”