198 Mycosis fungoides (cutaneous T-cell lymphoma) Instruction Look at this patient’s skin. Salient features History • Age (usually fifth and seventh decade) • Pruritus. Examination • Itchy, brownish-red plaques on the hips, buttocks and interscapular region (Fig. 198.1). Fig. 198.1 Patch-stage mycosis fungoides: itchy, brownish-red plaques. Proceed as follows: • Tell the examiner that it may also involve the lymph nodes and viscera. Diagnosis This patient has itchy brownish-red plaques with lymph node involvement (lesions), indicating mycosis fungoides (aetiology). Advanced-level questions How would you confirm the diagnosis? Skin biopsy to detect Pautrier’s microabscesses, atypical cells in the nests in the epidermis, atypical mononuclear cell infiltrates, large hyperchromic cells with irregular nuclei—the ‘mycosis cells’. The hallmark of mycosis fungoides is the identification of the Sézary–Lautner cells. These are T helper cells (CD4 positive) that characteristically form band-like aggregates within the superficial dermis and invade the dermis as single cells and small clusters (Pautrier’s microabscesses). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Mycosis fungoides (cutaneous T-cell lymphoma) Full access? Get Clinical Tree
198 Mycosis fungoides (cutaneous T-cell lymphoma) Instruction Look at this patient’s skin. Salient features History • Age (usually fifth and seventh decade) • Pruritus. Examination • Itchy, brownish-red plaques on the hips, buttocks and interscapular region (Fig. 198.1). Fig. 198.1 Patch-stage mycosis fungoides: itchy, brownish-red plaques. Proceed as follows: • Tell the examiner that it may also involve the lymph nodes and viscera. Diagnosis This patient has itchy brownish-red plaques with lymph node involvement (lesions), indicating mycosis fungoides (aetiology). Advanced-level questions How would you confirm the diagnosis? Skin biopsy to detect Pautrier’s microabscesses, atypical cells in the nests in the epidermis, atypical mononuclear cell infiltrates, large hyperchromic cells with irregular nuclei—the ‘mycosis cells’. The hallmark of mycosis fungoides is the identification of the Sézary–Lautner cells. These are T helper cells (CD4 positive) that characteristically form band-like aggregates within the superficial dermis and invade the dermis as single cells and small clusters (Pautrier’s microabscesses). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Mycosis fungoides (cutaneous T-cell lymphoma) Full access? Get Clinical Tree
