Staging Accuracy in Mycosis Fungoides and Sézary Syndrome Using Integrated Positron Emission Tomography and Computed Tomography

Abstract

To evaluate the usefulness of integrated positron emission tomography and computed tomography (PET/CT) in staging mycosis fungoides (MF) and Sézary syndrome and to correlate PET/CT data with histopathologic diagnosis of lymph nodes (LNs).Design: A single-center, prospective cohort analysis.Setting: Academic referral center for cutaneous lymphoma.Patients: Thirteen patients with MF and SS at risk for secondary LN involvement.Interventions: Patients were clinically evaluated based on general physical examination, total body skin examination, and laboratory screening. They underwent integrated PET/CT followed by excisional biopsy of LNs. Main Outcome Measures:We used PET/CT to assess LN size and metabolic activity. Enlarged LNs were defined as axillary or inguinal LNs with a short axis 1.5 cm or larger; or cervical LN, with a short axis 1.0 cm or larger. We classified LN pathologic results according to National Cancer Institute (LN1-4) and World Health Organization (WHO 1-3) criteria. We quantified PET ac-tivity using standardized uptake value (SUV) and correlated with LN grade.

TNM classification system for primary cutaneous lymphomas other than 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)

“…There is increasing evidence for added value in obtaining functional/metabolic information using positron emission tomography (PET) technique for staging and monitoring response to treatment in lymphoma. 10,11 More recently, the integrated PET/CT scanners have become available allowing the clinician to have simultaneous anatomic and functional/metabolic information of tumor spread/involvement 12,13 . In patients unable to safely undergo a CT scan, magnetic resonance imaging (MRI) studies are often substituted.…”

Subcutaneous panniculitis-like T-cell lymphoma with breast involvement: functional and morphological imaging findings

“…FDG-PET-CT is a powerful modality for the detection of nodal and visceral involvement in Hodgkin's (HD) and non-Hodgkin's lymphomas (NHL) [6,18]. But only a few reports of subcutaneous imaging-based findings in SPTCL [4,[9][10][11] and other cutaneous lymphomas exist in the literature [1,[3][4][5].…”

How I treat mycosis fungoides and Sézary syndrome

“…90 This patient developed LCT at the time of node biopsy. LCT is currently defined as the presence of large cells ($4 times the size of a small lymphocyte) in .25% of the infiltrate, or if these cells form microscopic nodules.…”