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

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==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(Mycosis fungoides (MF) and Sezary syndrome have same critera for staging) is provided in the following table:<ref name="TrautingerEder2017">{{cite journal|last1=Trautinger|first1=Franz|last2=Eder|first2=Johanna|last3=Assaf|first3=Chalid|last4=Bagot|first4=Martine|last5=Cozzio|first5=Antonio|last6=Dummer|first6=Reinhard|last7=Gniadecki|first7=Robert|last8=Klemke|first8=Claus-Detlev|last9=Ortiz-Romero|first9=Pablo L.|last10=Papadavid|first10=Evangelia|last11=Pimpinelli|first11=Nicola|last12=Quaglino|first12=Pietro|last13=Ranki|first13=Annamari|last14=Scarisbrick|first14=Julia|last15=Stadler|first15=Rudolf|last16=Väkevä|first16=Liisa|last17=Vermeer|first17=Maarten H.|last18=Whittaker|first18=Sean|last19=Willemze|first19=Rein|last20=Knobler|first20=Robert|title=European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2017|journal=European Journal of Cancer|volume=77|year=2017|pages=57–74|issn=09598049|doi=10.1016/j.ejca.2017.02.027}}</ref><ref name="pmid17540844">{{cite journal |vauthors=Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R, Zackheim H, Duvic M, Estrach T, Lamberg S, Wood G, Dummer R, Ranki A, Burg G, Heald P, Pittelkow M, Bernengo MG, Sterry W, Laroche L, Trautinger F, Whittaker S |title=Revisions to the staging and classification of mycosis fungoides and Sezary 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) |journal=Blood |volume=110 |issue=6 |pages=1713–22 |date=September 2007 |pmid=17540844 |doi=10.1182/blood-2007-03-055749 |url=}}</ref>
{| class="wikitable"
|+
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Staging for mycosis fungoides and Sezary syndrome
|-
! colspan="3" style="background: #B0C4DE; color: #FFFFFF; text-align: center;" |'''[[Skin]] (T)'''
|-
| align="center" style="background:#ADD8E6;" |T1
|Limited patches, [[Papule|papules]], and/or [[Plaque|plaques]] covering <10% of the [[skin]] [[Surface area|surface]]. May further stratify into T1a ([[Patched|patch]] only) versus T1b ([[plaque]]  [[Patched|patch]])
|-
| align="center" style="background:#ADD8E6;" |T2
|Patches, [[Papule|papules]], [[or]] [[Plaque|plaques]] covering 10% of the [[skin]] [[Surface area|surface]]. May further stratify into T2a (patch only) versus T2b ([[plaque]]  patch).
|-
| align="center" style="background:#ADD8E6;" |T3
|One or more [[Tumor|tumours]] (1-cm diameter)
|-
| align="center" style="background:#ADD8E6;" |T4
|Confluence of [[erythema]] covering 80% [[body surface area]]
|-
! colspan="3" style="background: #B0C4DE; color: #FFFFFF; text-align: center;" |'''Node (N)'''
|-
| align="center" style="background:#ADD8E6;" |N0
|No [[Clinical|clinically]] [[abnormal]] [[T-cell lymphoma classification|peripheral]] [[Lymph node|lymph nodes]]; [[biopsy]] not required
|-
| align="center" style="background:#ADD8E6;" |N1
|Clinically [[abnormal]] [[Lymph node|lymph nodes]]; [[histopathology]] Dutch grade 1 or [[NCI]] LN0-2
|-
| align="center" style="background:#ADD8E6;" |N1a
|[[Clone]] negative
|-
| align="center" style="background:#ADD8E6;" |N1b
|[[Clone]] posetive
|-
| align="center" style="background:#ADD8E6;" |N2
|[[Clinical|Clinically]] [[abnormal]] [[T-cell lymphoma classification|peripheral]] [[Lymph node|lymph nodes]]; [[histopathology]] Dutch grade 2 or [[NCI]] LN3
|-
| align="center" style="background:#ADD8E6;" |N2a
|[[Clone]] negatove
|-
| align="center" style="background:#ADD8E6;" |N2b
|[[Clone]] posetive
|-
| align="center" style="background:#ADD8E6;" |N3
|[[Clinical|Clinically]] [[abnormal]] [[T-cell lymphoma classification|peripheral]] [[Lymph node|lymph nodes]]; [[histopathology]] Dutch grades 3e4 or [[NCI]] LN4; [[clone]] positive or negative
|-
| align="center" style="background:#ADD8E6;" |NX
|[[Clinical|Clinically]] [[abnormal]] [[T-cell lymphoma classification|peripheral]] [[Lymph node|lymph nodes]]; no [[histologic]] confirmation
|-
! colspan="3" style="background: #B0C4DE; color: #FFFFFF; text-align: center;" |[[Visceral|'''Visceral''']] ('''M''')
|-
| align="center" style="background:#ADD8E6;" |M0
|No [[visceral]] [[Organ (anatomy)|organ]] involvement
|-
| align="center" style="background:#ADD8E6;" |M1
|[[Visceral]] involvement (must have [[pathology]] confirmation and [[Organ (anatomy)|organ]] involved should be specified)
|-
! colspan="3" style="background: #B0C4DE; color: #FFFFFF; text-align: center;" |[[Blood|'''Blood''']] '''(B)'''
|-
| align="center" style="background:#ADD8E6;" |B0
|0 Absence of significant [[blood]] involvement: 5% of [[T-cell lymphoma classification|peripheral]] [[blood]] [[Lymphocyte|lymphocytes]] are atypical (Sezary) [[Cell (biology)|cell]]<nowiki/>s B0a [[Clone]] negative B0b [[Clone (cell biology)|Clone]] positive
|-
| align="center" style="background:#ADD8E6;" |B1
|Low [[blood]] [[Tumor|tumour]] burden: >5% of [[T-cell lymphoma classification|peripheral]] [[blood]] [[Lymphocyte|lymphocytes]] are atypical (Sezary) cells but does not meet the [[criteria]] of B2 B1a Clone negative B1b [[Clone (cell biology)|Clone]] positive
|-
| align="center" style="background:#ADD8E6;" |B2
|High [[blood]] tumour burden: 1000/mL Sezary [[Cell (biology)|cells]] with positive clone
|}
The staging of [[Sezary syndrome]] is based on the [[clinical]] stages:<ref name="TrautingerEder2017" /><ref name="JawedMyskowski2014">{{cite journal|last1=Jawed|first1=Sarah I.|last2=Myskowski|first2=Patricia L.|last3=Horwitz|first3=Steven|last4=Moskowitz|first4=Alison|last5=Querfeld|first5=Christiane|title=Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome)|journal=Journal of the American Academy of Dermatology|volume=70|issue=2|year=2014|pages=205.e1–205.e16|issn=01909622|doi=10.1016/j.jaad.2013.07.049}}</ref>
{| class="wikitable"
|+
! colspan="6" style="background: #4479BA; color: #FFFFFF; text-align: center;" !colspan="3" |clinical stages
|-
| align="center" style="background:#4479BA;" |Stage
! colspan="1" style="background: #B0C4DE; color:#FFFFFF; text-align: center;" |T
! colspan="1" style="background: #B0C4DE; color:#FFFFFF; text-align: center;" |N
! colspan="1" style="background: #B0C4DE; color:#FFFFFF; text-align: center;" |M
! colspan="1" style="background: #B0C4DE; color:#FFFFFF; text-align: center;" |B
! colspan="1" style="background: #B0C4DE; color:#FFFFFF; text-align: center;" |DDS
|-
| align="center" style="background:#ADD8E6;" |IA
|1
|0
|0
|0/1
|98
|-
| align="center" style="background:#ADD8E6;" |IB
|2
|0
|0
|0/1
|89
|-
| align="center" style="background:#ADD8E6;" |IIA
|1.2
|1.2
|0
|0/1
|89
|-
| align="center" style="background:#ADD8E6;" |IIB
|3
|0-2
|0
|0/1
|56
|-
| align="center" style="background:#ADD8E6;" |IIIA
|4
|0-2
|0
|0
|54
|-
| align="center" style="background:#ADD8E6;" |IIIB
|4
|0-2
|0
|1
|48
|-
| align="center" style="background:#ADD8E6;" |IVA1
|1-4
|0-2
|0
|2
|41
|-
| align="center" style="background:#ADD8E6;" |IVA2
|1-4
|3
|0
|0-2
|23
|-
| align="center" style="background:#ADD8E6;" |IVB
|1-4
|0-3
|1
|0-2
|18
|}
*[5-year [[disease]] free [[survival]] (DSS)]
* [[Cancer]] has spread to other [[Organ (anatomy)|organs]] in the [[Human body|body]], including the [[blood]] and [[bone marrow]]
* [[Lymph node|Lymph nodes]] may be enlarged and may contain [[cancer]]


==References==
==References==

Latest revision as of 13:20, 7 February 2019


Mycosis fungoides Microchapters

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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


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