Mycosis Fungoides

Mycosis Fungoides – A disease in which a type of white blood cell (lymphocytes) become malignant (cancerous) and affect the skin. It is a type of cutaneous T-cell lymphoma.

What is Mycosis Fungoides?

Mycosis fungicides are malignant T-cell lymphocytes that affect the skin. T-cell lymphocytes that help B-lymphocytes make the antibodies that help fight infection. Mycosis fungoides and the Sezary syndrome are the two most common types of cutaneous T-cell lymphoma (a type of non-Hodgkin lymphoma). Sezary syndrome occurs when the T-cell lymphocytes can also be found in the blood.

Symptoms

Mycosis fungoides may go through the following phases: Premycotic phase: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years. It is hard to diagnose the rash as mycosis fungoides during this phase. Patch phase: Thin, reddened, eczema -like rash. Plaque phase: Small raised bumps (papules) or hardened lesions on the skin, which may be reddened. Tumor phase: Tumors form on the skin. These tumors may develop ulcers and the skin may get infected.

Diagnosis

Tests that examine the skin are used to detect (find) and diagnose mycosis fungoides. Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps, the number and type of skin lesions, or anything else that seems unusual.
  • Complete blood count with differential
  • Complete blood count (CBC)
  • Peripheral blood smear
  • Skin biopsy
  • Immunophenotyping
  • T-cell receptor (TCR) gene rearrangement test
  • Flow cytometry
After mycosis fungoides and the Sézary syndrome have been diagnosed, tests are done to find out if cancer cells have spread from the skin to other parts of the body. The following procedures may be used in the staging process:
  • Chest x-ray
  • CT scan (CAT scan)
  • PET scan (positron emission tomography scan)
  • Lymph node biopsy : The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.
  • Bone marrow aspiration and biopsy
Cancer can spread through tissue, the lymph system, and the blood: when cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

Staging

The following stages are used for mycosis fungoides and the Sézary syndrome:

Stage I Mycosis Fungoides

Stage I is divided into stage IA and stage IB as follows: Stage IA: Less than 10% of the skin surface is covered with patches, papules, and/or plaques. Stage IB: Ten percent or more of the skin surface is covered with patches, papules, and/or plaques. There may be abnormal lymphocytes in the blood but they are not cancerous.

Stage II Mycosis Fungoides

Stage II is divided into stage IIA and stage IIB as follows: Stage IIA: Any amount of the skin surface is covered with patches, papules, and/or plaques. Lymph nodes are enlarged but cancer has not spread to them. Stage IIB: One or more tumors that are 1 centimeter or larger are found on the skin. Lymph nodes may be enlarged but cancer has not spread to them. There may be abnormal lymphocytes in the blood but they are not cancerous.

Stage III Mycosis Fungoides

In stage III, nearly all of the skin is reddened and may have patches, papules, plaques, or tumors. Lymph nodes may be enlarged but cancer has not spread to them. There may be abnormal lymphocytes in the blood but they are not cancerous.

Stage IV Mycosis Fungoides

Stage IV is divided into stage IVA and stage IVB as follows: Stage IVA: Most of the skin is reddened and any amount of the skin surface is covered with patches, papules, plaques, or tumors, and either; cancer has spread to lymph nodes and there may be cancerous lymphocytes in the blood; or there are cancerous lymphocytes in the blood and lymph nodes may be enlarged, but cancer has not spread to them. Stage IVB: Most of the skin is reddened and any amount of the skin surface is covered with patches, papules, plaques, or tumors. Cancer has spread to other organs in the body. Lymph nodes may be enlarged and cancer may have spread to them. There may be cancerous lymphocytes in the blood.

Stage IV Sézary Syndrome

In stage IV: Most of the skin is reddened and covered with patches, papules, plaques, or tumors. There is a high level of cancerous lymphocytes in the blood. Lymph nodes may be enlarged and cancer may have spread to them.