Mycosis fungoides natural history, complications and prognosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(55 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Cutaneous T cell lymphoma}}
 
{{CMG}}; {{AE}} {{AS}}
{{Mycosis fungoides}}
{{CMG}}; {{AE}} {{S.G.}}
==Overview==
==Overview==
If left untreated, cutaneous T cell lymphoma may progress to develop cutaneous patches, plaque, and tumors. Depending on the extent of the lymphoma at the time of diagnosis, the prognosis may vary.
If left untreated, [[cutaneous T cell lymphoma|mycosis fungoides]] may progress to develop [[cutaneous]] [[Patched|patches]], [[plaque]], and [[Tumor|tumors]]. Depending on the extent of the [[lymphoma]] at the time of [[diagnosis]], the [[prognosis]] may vary.
==Natural History==
==Natural History==
* Mycosis fungoides is initially an indolent lymphoma that may later develop peripheral lymphadenopathy and can finally progress to widespread visceral involvement.<ref name=radio>Mycosis fungoides. Radiopaedia.http://radiopaedia.org/articles/mycosis-fungoides Accessed on January 20, 2016</ref>
*The [[Symptom|symptoms]] of mycosis fungoides usually develop as non-specific, [[Indolent ulcer|indolent]] inflammation such as etopic [[dermatitis]], nonspecific [[Chronic (medical)|chronic]] [[dermatitis]], or [[parapsoriasis]] ( large-[[plaque]] [[parapsoriasis]]).<ref name="QuaglinoPimpinelli20123">{{cite journal|last1=Quaglino|first1=Pietro|last2=Pimpinelli|first2=Nicola|last3=Berti|first3=Emilio|last4=Calzavara-Pinton|first4=Piergiacomo|last5=Alfonso Lombardo|first5=Giuseppe|last6=Rupoli|first6=Serena|last7=Alaibac|first7=Mauro|last8=Bottoni|first8=Ugo|last9=Carbone|first9=Angelo|last10=Fava|first10=Paolo|last11=Fimiani|first11=Michele|last12=Mamusa|first12=Angela Maria|last13=Titli|first13=Stefano|last14=Zinzani|first14=Pier Luigi|last15=Bernengo|first15=Maria Grazia|title=Time course, clinical pathways, and long-term hazards risk trends of disease progression in patients with classic mycosis fungoides|journal=Cancer|volume=118|issue=23|year=2012|pages=5830–5839|issn=0008543X|doi=10.1002/cncr.27627}}</ref>
* Cutaneous T cell lymphoma is usually initially seen by dermatologists with patients presenting with skin lesions.
*The majority of [[Patient|patients]] have early stage (77.9% : IA stage IA 38.8%, stage IB  39.1% ), and [[Patient|patients]] with stage IIB diagnosed in 5.5% and stage III observed in 6.6%. The majority of patients of mycosis fungoides are not diagnosed and end stage not be observed.<ref name="QuaglinoPimpinelli20123" />
* Patients often have a history of several years of eczematous or dermatitic skin lesions before the diagnosis is finally established.
*Mycosis fungoides in early stage is characterized by non-specific [[dermatitis]] or consistent [[Patched|patches]] observed on the lower [[trunk]] and [[buttocks]].<ref name="QuaglinoPimpinelli20123" />
* The skin lesions then progress from the patch stage to the [[plaque]] stage to cutaneous tumors.
* Mycosis fungoides initiates as an [[Indolent ulcer|indolent]] [[lymphoma]] that may later develop peripheral [[lymphadenopathy]] and may finally progress to widespread visceral involvement.<ref name="radio">Mycosis fungoides. Radiopaedia.http://radiopaedia.org/articles/mycosis-fungoides Accessed on January 20, 2016</ref>
* [[Patient|Patients]] often have a history of several years of [[Eczema|eczematous]] or [[dermatitis]] [[skin]] [[Lesion|lesions]] before the diagnosis is finally established.<ref name="QuaglinoPimpinelli20123" />
* The [[skin]] [[Lesion|lesions]] then progress from the patch stage to the [[plaque]] stage to [[cutaneous]] [[Tumor|tumors]].<ref name="QuaglinoPimpinelli20123" />
 
==Complications==
*Common complications of mycosis fungoides include:<ref name="pmid28832009">{{cite journal |vauthors=Cengiz FP, Emiroğlu N, Onsun N |title=Frequency and Risk Factors for Secondary Malignancies in Patients with Mycosis Fungoides |journal=Turk J Haematol |volume=34 |issue=4 |pages=378–379 |date=December 2017 |pmid=28832009 |pmc=5774354 |doi=10.4274/tjh.2017.0234 |url=}}</ref><ref name="LawTeicher2003">{{cite journal|last1=Law|first1=Meng|last2=Teicher|first2=Noah|last3=Zagzag|first3=David|last4=Knopp|first4=Edmond A.|title=Dynamic contrast enhanced perfusion MRI in mycosis fungoides|journal=Journal of Magnetic Resonance Imaging|volume=18|issue=3|year=2003|pages=364–367|issn=1053-1807|doi=10.1002/jmri.10361}}</ref><ref name="BassunerMiranda2016">{{cite journal|last1=Bassuner|first1=Juri|last2=Miranda|first2=Roberto N.|last3=Emge|first3=Drew A.|last4=DiCicco|first4=Beau A.|last5=Lewis|first5=Daniel J.|last6=Duvic|first6=Madeleine|title=Mycosis Fungoides of the Oral Cavity: Fungating Tumor Successfully Treated with Electron Beam Radiation and Maintenance Bexarotene|journal=Case Reports in Dermatological Medicine|volume=2016|year=2016|pages=1–7|issn=2090-6463|doi=10.1155/2016/5857935}}</ref><ref name="pmid6640491">{{cite journal |vauthors=Price NM, Hoppe RT, Deneau DG |title=Ointment-based mechlorethamine treatment for mycosis fungoides |journal=Cancer |volume=52 |issue=12 |pages=2214–9 |date=December 1983 |pmid=6640491 |doi= |url=}}</ref><ref name="pmid3722479">{{cite journal |vauthors=Abel EA, Sendagorta E, Hoppe RT |title=Cutaneous malignancies and metastatic squamous cell carcinoma following topical therapies for mycosis fungoides |journal=J. Am. Acad. Dermatol. |volume=14 |issue=6 |pages=1029–38 |date=June 1986 |pmid=3722479 |doi= |url=}}</ref>
**Mycosis Fungoides increases risk of secondary [[malignancies]] such as primary [[malignancy]], especially [[Hodgkin's lymphoma|Hodgkin lymphoma]], [[Chronic (medical)|chronic]] [[leukemia]], and [[lung]] [[cancer]].
**[[Neurologic]] involvement (intracerebral mycosis fungoides)
**[[Oral]] involvement
**[[Hypersensitivity]] reaction with [[topical]] HN2 [[therapy]]
**[[Hypopigmentation]] or [[hyperpigmentation]] of treated areas
 
==Prognosis==
==Prognosis==
* Cutaneous T cell lymphoma is usually a slow-growing (indolent) lymphoma.<ref name= canadiancancer> Cutaneous T cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/cutaneous-t-cell-lymphoma/?region=on Accessed on January 19, 2016</ref>
* Cutaneous T cell lymphoma is usually a slow-growing (indolent) [[lymphoma]].<ref name="canadiancancer">Cutaneous T cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/cutaneous-t-cell-lymphoma/?region=on Accessed on January 19, 2016</ref>
* The prognosis for people with cutaneous T cell lymphoma is based on the extent of disease and how the person responds to treatment.  
* The [[prognosis]] for people with [[cutaneous T cell lymphoma]] is based on the extent of [[disease]] and how the person responds to treatment.  
* Although more advanced stages of cutaneous T cell lymphoma may not be cured, the lymphoma can still be controlled with treatment.
* Although more advanced stages of [[cutaneous T cell lymphoma]] may not be cured, the [[Lymphomas|lymphoma]] can still be controlled with treatment
===Favorable prognosis===
===Favorable prognosis===
* Early stage disease
* Early stage [[disease]]
* Lymphoma is confined to the skin
* [[Lymphoma]] is confined to the [[skin]]
===Unfavorable prognosis===
===Unfavorable prognosis===
* More advanced disease
* More advanced [[disease]]
* Lymphoma has spread to lymph nodes  
* [[Lymphoma]] has spread to [[Lymph node|lymph nodes]]
* Lymphoma has spread to other organs
* [[Lymphoma]] has spread to other [[Organ (anatomy)|organs]]
 
 
==Staging==
The staging of cutaneous T cell lymphoma is based on skin and lymph node involvement.<ref name= canadiancancer> Cutaneous T cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/cutaneous-t-cell-lymphoma/?region=on Accessed on January 19, 2016</ref> Staging for cutaneous T cell lymphoma  is provided in the following table:


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+ '''Staging of cutaneous T cell lymphoma <ref name= canadiancancer> Cutaneous T cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/cutaneous-t-cell-lymphoma/?region=on Accessed on January 19, 2016</ref>'''
! style="background: #4479BA; color:#FFF;" | Stage
! style="background: #4479BA; color:#FFF;" | Involvement
|-
| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''stage I'''
|-
| style="padding: 5px 5px; background: #F5F5F5;" | I A
| style="padding: 5px 5px; background: #F5F5F5;" |
* Less than 10% of the skin is covered with patches or plaques
|-
| style="padding: 5px 5px; background: #F5F5F5;" | I B
| style="padding: 5px 5px; background: #F5F5F5;" |
* 10% or more of the skin is covered with patches or plaques
|-
| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''stage II'''
|-
| style="padding: 5px 5px; background: #F5F5F5;" | II A
| style="padding: 5px 5px; background: #F5F5F5;" |
* Any amount of the skin is covered in patches or plaques
* Lymph nodes are enlarged, but do not contain cancer
|-
| style="padding: 5px 5px; background: #F5F5F5;" | II B
| style="padding: 5px 5px; background: #F5F5F5;" |
* There is one or more raised tumors on the skin
* Lymph nodes may or may not be enlarged and do not contain cancer
|-
| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''stage III'''
|-
| style="padding: 5px 5px; background: #F5F5F5;" | III
| style="padding: 5px 5px; background: #F5F5F5;" |
* Almost all of the skin is reddened
* There may or may not be patches, plaques or skin tumors
* Lymph nodes may or may not be enlarged and do not contain cancer
|-
| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''stage IV'''
|-
| style="padding: 5px 5px; background: #F5F5F5;" | IV A
| style="padding: 5px 5px; background: #F5F5F5;" |
* Cancer has spread to the lymph nodes, but not to other organs in the body
|-
| style="padding: 5px 5px; background: #F5F5F5;" | IV B
| style="padding: 5px 5px; background: #F5F5F5;" |
* Cancer has spread to other organs in the body, including the blood and bone marrow
* Lymph nodes may be enlarged and may contain cancer
|}




Latest revision as of 13:20, 7 February 2019


Mycosis fungoides Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Mycosis Fungoides from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

X-Ray

CT Scan

MRI

Echocardiography and Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Mycosis fungoides natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Mycosis fungoides natural history, complications and prognosis

All Images
X-rays
Echo and Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Mycosis fungoides natural history, complications and prognosis

CDC on Mycosis fungoides natural history, complications and prognosis

Mycosis fungoides natural history, complications and prognosis in the news

Blogs on Mycosis fungoides natural history, complications and prognosis

Directions to Hospitals Treating Mycosis fungoides

Risk calculators and risk factors for Mycosis fungoides natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

Overview

If left untreated, mycosis fungoides may progress to develop cutaneous patches, plaque, and tumors. Depending on the extent of the lymphoma at the time of diagnosis, the prognosis may vary.

Natural History

Complications

Prognosis

Favorable prognosis

Unfavorable prognosis


References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Quaglino, Pietro; Pimpinelli, Nicola; Berti, Emilio; Calzavara-Pinton, Piergiacomo; Alfonso Lombardo, Giuseppe; Rupoli, Serena; Alaibac, Mauro; Bottoni, Ugo; Carbone, Angelo; Fava, Paolo; Fimiani, Michele; Mamusa, Angela Maria; Titli, Stefano; Zinzani, Pier Luigi; Bernengo, Maria Grazia (2012). "Time course, clinical pathways, and long-term hazards risk trends of disease progression in patients with classic mycosis fungoides". Cancer. 118 (23): 5830–5839. doi:10.1002/cncr.27627. ISSN 0008-543X.
  2. ↑ Mycosis fungoides. Radiopaedia.http://radiopaedia.org/articles/mycosis-fungoides Accessed on January 20, 2016
  3. ↑ Cengiz FP, Emiroğlu N, Onsun N (December 2017). "Frequency and Risk Factors for Secondary Malignancies in Patients with Mycosis Fungoides". Turk J Haematol. 34 (4): 378–379. doi:10.4274/tjh.2017.0234. PMC 5774354. PMID 28832009.
  4. ↑ Law, Meng; Teicher, Noah; Zagzag, David; Knopp, Edmond A. (2003). "Dynamic contrast enhanced perfusion MRI in mycosis fungoides". Journal of Magnetic Resonance Imaging. 18 (3): 364–367. doi:10.1002/jmri.10361. ISSN 1053-1807.
  5. ↑ Bassuner, Juri; Miranda, Roberto N.; Emge, Drew A.; DiCicco, Beau A.; Lewis, Daniel J.; Duvic, Madeleine (2016). "Mycosis Fungoides of the Oral Cavity: Fungating Tumor Successfully Treated with Electron Beam Radiation and Maintenance Bexarotene". Case Reports in Dermatological Medicine. 2016: 1–7. doi:10.1155/2016/5857935. ISSN 2090-6463.
  6. ↑ Price NM, Hoppe RT, Deneau DG (December 1983). "Ointment-based mechlorethamine treatment for mycosis fungoides". Cancer. 52 (12): 2214–9. PMID 6640491.
  7. ↑ Abel EA, Sendagorta E, Hoppe RT (June 1986). "Cutaneous malignancies and metastatic squamous cell carcinoma following topical therapies for mycosis fungoides". J. Am. Acad. Dermatol. 14 (6): 1029–38. PMID 3722479.
  8. ↑ Cutaneous T cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/cutaneous-t-cell-lymphoma/?region=on Accessed on January 19, 2016


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Mycosis_fungoides_natural_history,_complications_and_prognosis&oldid=1546901"