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Validation of an algorithm based on clinical, histopathological and immunohistochemical data for the diagnosis of early-stage mycosis fungoides
Postgraduate Program in Anatomical PathologyAmorim, Gustavo Moreira; Department of PathologyQuintella, Daniele Carvalho; Dermatology ServiceNiemeyer-Corbellini, João Paulo; Ferreira, Luiz Claudio; Departamento de Clínica MédicaRamos-e-Silva, Marcia; Postgraduate Program in Anatomical PathologyCuzzi, Tullia.
  • Postgraduate Program in Anatomical PathologyAmorim, Gustavo Moreira; Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Postgraduate Program in Anatomical PathologyAmorim, Gustavo Moreira. Rio de Janeiro. BR
  • Department of PathologyQuintella, Daniele Carvalho; Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Department of PathologyQuintella, Daniele Carvalho. Rio de Janeiro. BR
  • Dermatology ServiceNiemeyer-Corbellini, João Paulo; Universidade Federal do Rio de Janeiro. Hospital Universitário. Dermatology ServiceNiemeyer-Corbellini, João Paulo. Rio de Janeiro. BR
  • Ferreira, Luiz Claudio; Fundação Oswaldo Cruz. Instituto Nacional de Infectologia. Rio de Janeiro. BR
  • Departamento de Clínica MédicaRamos-e-Silva, Marcia; Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Clínica MédicaRamos-e-Silva, Marcia. Rio de Janeiro. BR
  • Postgraduate Program in Anatomical PathologyCuzzi, Tullia; Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Postgraduate Program in Anatomical PathologyCuzzi, Tullia. Rio de Janeiro. BR
An. bras. dermatol ; 95(3): 326-331, May-June 2020. tab, graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130881
ABSTRACT
Abstract

Background:

Diagnosis of mycosis fungoides is challenging due to the non-specificity of clinical and histopathological findings. The literature indicates an average delay of 4-6 years for a conclusive diagnosis. Refinement of the histopathological criteria for the diagnosis of patients in early stages of the disease is considered of interest.

Objectives:

To study the histopathological aspects of early-stage mycosis fungoides and the applicability, in a retrospective form, of the diagnostic algorithm proposed by Pimpinelli et al.

Methods:

Observational, retrospective, transversal study based on revision of histopathological exams of patients with suspected mycosis fungoides. Medical records were reviewed, and complementary immunohistochemistry performed.

Results:

Sixty-seven patients were included. The most frequent histopathological features were superficial perivascular lymphoid infiltrate (71.6%), epidermotropism (68.7%), lymphocytic atypia (63.8%), hyperkeratosis (62.7%) and acanthosis (62.7%). Forty-three patients scored 4 points at the algorithm, by clinical and histological evaluation. Immunohistochemistry was performed on 23 of the 24 patients with less than 4 points. Of those 23, 22 scored 1 point, allowing a total of 61 patients (91%) with the diagnosis of early-stage mycosis fungoides. Study

limitations:

Its retrospective character, reduced sample size and incomplete application of the algorithm.

Conclusions:

Application of the Pimpinelli et al. algorithm, even in an incomplete form, increased the percentage of cases diagnosed as mycosis fungoides. Routine application of the algorithm may contribute to earlier and specific management and improvement of the patients' outcome.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Algorithms / Mycosis Fungoides Type of study: Diagnostic study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: An. bras. dermatol Year: 2020 Type: Article Institution/Affiliation country: Fundação Oswaldo Cruz/BR / Universidade Federal do Rio de Janeiro/BR

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Full text: Available Index: LILACS (Americas) Main subject: Algorithms / Mycosis Fungoides Type of study: Diagnostic study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: An. bras. dermatol Year: 2020 Type: Article Institution/Affiliation country: Fundação Oswaldo Cruz/BR / Universidade Federal do Rio de Janeiro/BR