The histological prevalence and clinical implications of folliculotropism and syringotropism in mycosis fungoides
| Autor: | Tara Jennings, Joya Sahu, Inna Chervoneva, Barbara Pro, Wenyin Shi, Ashley Gochoco, Claudia Hossain, Pierluigi Porcu, S. Onder Alpdogan, Robert Duffy, Kelly Knoblauch |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Skin Neoplasms SWEAT 030207 dermatology & venereal diseases 03 medical and health sciences Mycosis Fungoides 0302 clinical medicine Biopsy Humans Medicine Prospective Studies Stage (cooking) Body surface area Mycosis fungoides medicine.diagnostic_test business.industry General Medicine medicine.disease Dermatology Lymphoma Oncology 030220 oncology & carcinogenesis Female Histopathology Observational study business Hair Follicle |
| Zdroj: | Chinese Clinical Oncology. 8:6-6 |
| ISSN: | 2304-3873 2304-3865 |
| DOI: | 10.21037/cco.2018.10.02 |
| Popis: | Background: Mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma, remains a challenge for clinicians to stage and manage. Classically, MF is determined through histopathologic evidence of a neoplastic infiltrate within the epidermis. In certain patients, however, the infiltrate extends into the hair follicles and sweat glands. The objective of this study is to determine the utility of expanding the analysis of histopathology reports to include the reporting of folliculotropism and syringotropism. Methods: This is a prospective, observational study conducted in a single facility from 2012-2018. All patients with MF, excluding those treated at this facility for less than six months with the exception of those with incomplete pruritus documentation, or absence of initial biopsy analysis were studied. Modified severity weighted assessment tool (mSWAT) quantified body surface area and treatments attempted per patient were continuously charted. Patients were surveyed for presence and degree of pruritus and pain. Evaluation of these parameters were charted at the initial patient visit and correlated with their primary biopsy for presence or absence of folliculotropism and syringotropism. Results: Of the 87 patients examined, 70 patients (80%) exhibited syringotropism in their original biopsy and 68 patients (78%) exhibited folliculotropism. Presence of both findings concurrently was present in 56 patients (64.4%), while neither finding was present in 5 patients (5.8%). The singular finding of folliculotropism was found in 12 patients (13.8%), while the singular finding of syringotropism was exhibited in 14 patients (16.1%). A significant association between the presence of folliculotropism and pruritus was established (P=0.043, a=0.05). The general trend towards increase in mSWAT score and pruritus in patients in regard to the mean and median values suggest that increasing the sample population of the study might yield a significant value in the future. Conclusions: These presentations are more prevalent than previously recognized and have findings indicative of more severe disease. We propose that MF histopathology reports document the presence of folliculotropism and syringotropism and that these findings be added to the NCCN guidelines as they may aid in predicting severity and progression risk. |
| Databáze: | OpenAIRE |
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