CORRESPONDENCE
*
Luciana Baptista Pereira
Discussion about the existence of unilesional form of mycosis fungoides
MSc - Assistant Professor of Dermatology, Federal University of Minas Gerais (UFMG) - Belo Horizonte (MG), Brazil
It was with great interest that I read the case described in the section "What is your Diagnosis", published in November/December of 2010. The authors described the case of a patient with a single lesion diagnosed as unilesional mycosis fungoides (MF).
According to the WHO-EORTC consensus classification, published in J 2005, MF is defined as primary cutaneous T cell lymphoma, of indolent course, clinically characterized by the presence of patches, plaques and possibly tumors. When there are only tumors without patches and/or preceding plaques, the diagnosis of MF becomes highly improbable and another primary cutaneous T-cell lymphoma should be considered.
Among the variants and subtypes of MF considered to have distinct clinicopathological features, we could think of pagetoid reticulosis, which may present as a single lesion but is histologically characterized by the proliferation of intraepidermal neoplastic T cells, without atypical lymphocytes in the dermis, as described in the case reported.
Considering the information given in the article that lymphocytes in the case reported are CD30 negative, I would classify this lesion into the group of primary cutaneous peripheral T-cell lymphomas, without further specification. This group consists of heterogeneous neoplasms that do not fit into other well-defined subtypes of cutaneous T-cell lymphomas.
In 2008 the World Health Organization published a new consensus report about tumors of haematopoietic and lymphoid tissues. 2 It also established that the term 'mycosis fungoides' should be used only for the classic cases of the disease, characterized by the evolution of patches, plaques and tumors.
I believe that the classification of the subtype of this patient's cutaneous lymphoma should be reassessed by means of a larger immunohistochemical study.
REFERENCES
- 1. Willemze R, Jaffe ES, Burg G, Cerroni L, Berti E, Swerdlow SH, et al. WHO-EORTC classification for cutaneous lymphoma. Blood. 2005;105:3768-85.
- 2. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, eds., et al. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon, France: IARC Press; 2008.
Publication Dates
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Publication in this collection
16 May 2011 -
Date of issue
Apr 2011
