Quantitative electron microscopy in the diagnosis of mycosis fungoides. A simple analysis of lymphocytic nuclear convolutions

Abstract

In the present study we compared the accuracy of three different ultrastructural methods used to confirm clinically proved cases of mycosis fungoides (MF) from skin biopsy specimens. Method 1 is a qualitative method and confirmed the diagnosis of MF in only 44% of the patients with MF. Method 2 involved image analysis of lymphocytic nuclei and confirmed the diagnosis of MF in only 67% of the patients with MF. The most sensitive ultrastructural method for confirming the diagnosis of MF was a simple scoring of the number of sharply angled nuclear invaginations in 100 lymphocytes (method 3). Control biopsy specimens had many more lymphocytes (19% to 55%) with no sharply angled nuclear invaginations compared with those from patients with MF (3% to 15%). The clinical diagnosis of MF was confirmed in 100% of our patients with MF using method 3.

Morphometrical analysis of mycosis fungoides on paraffin‐embedded sections*

“…However, Eng found that nuclear contour ratios in all stages of MF are not statistically diiferent from that of cells infiltrating the skin in various benign dermatoses (23). Both the percentage of lymphocytes having distinct nuclear invaginations and the NCIs of cells stained with anti-T-cell monoclonal antibodies have been measured to discriminate between early MF and benign skin diseases with lymphoeytie infiltrates (13,15). Similar investigations were conducted on semithin sections by calculating a nuclear shape index (7).…”

“…However, early diagnosis is of great importance for prognostic and therapeutie reasons. A number of authors described semiquantitative and quantitative methods using Feulgen DNA-cytophotometry (4, 5), semithin (6, 7) and ultrathin sections (8)(9)(10)(11)(12)(13)(14) or a combination of electron microscopy atid immunohistoehemieal techniques (15,16) in order to facilitate diagnosis of early MF.…”

A simple clinical scoring system to improve the sensitivity and standardization of the diagnosis of mycosis fungoides type cutaneous T-cell lymphoma: logistic regression of clinical and laboratory data

“…To improve the reproducibility and sensitivity of the diagnosis of MF, key histological features have been identified 5–8 and several adjunctive tests developed through the years. To define the malignant infiltrate, various tests have been employed: abnormal nuclear DNA content and chromosome complement, 9–12 abnormal nuclear contour and shape, 13–17 loss of pan T‐cell markers, 18,19 elevated CD4/CD8 ratio (≥ 6), 20 diffuse epidermal HLA‐DR expression, 21 and the presence of a clonal T‐cell population as measured by T‐cell receptor gene rearrangement (TCR‐GR) studies 22–25 . None of these tests alone firmly establishes the diagnosis of MF.…”

Μορφολογική Και Ανοσοϊστοχημική Διερεύνηση Βιοψιών Δέρματος Σε Ασθενείς Με Σπογγοειδή Μυκητίαση

“…Συχνά στην tMF απαντάται ένα πλέον ευμέγεθες κύτταρο, περιγραφέν και ως πλειόμορφο κύτταρο, με φυσσαλιδώδη πυρήνα, εμφανέστατο πυρήνιο και ποικίλο αριθμό εντομών [Tykocinski, 1984;Vonderheid, 1981]. Επίσης, με παλαιότερες ποσοτικές μετρήσεις μέσω ΕΜ έχει ανευρεθεί ότι τα κύτταρα με πυρηνικές εντομές, παρόλο που χαρακτηρίζουν και άλλα λεμφώματα, είναι περισσότερα στην MF [Rieger, 1989;Payne, 1986Payne, ,1984.…”