PDF(Pubmed)
Abstract：
Primary cutaneous lymphomas (PCLs), especially mycosis fungoides (MF), pose significant diagnostic and therapeutic challenges. This study aims to correlate initial histological features with the disease course and survival in MF patients. A retrospective-prospective cohort study was conducted on 83 patients diagnosed with early-stage MF at the Departments of Dermatovenerology and Pathology, UHC Zagreb, from January 2003 to December 2012. The analyzed histopathological parameters included lichenoid dermal lymphocyte infiltrate, Pautrier microabscesses, and lymphocyte atypia. Patients with more than 30 guardian lymphocytes per 100 keratinocytes exhibited worse overall and progression-free survival. Furthermore, those with over 50% atypical lymphocytes demonstrated a faster progression rate. A dense lichenoid dermal infiltrate and a high count of lymphocyte \"keepers\" significantly increased the mortality risk within five years of diagnosis. This study did not fully confirm the hypothesis regarding the prognostic value of large Pautrier microabscesses but highlighted the importance of dense lichenoid infiltrates. The study identified new potential histopathological prognostic factors in early-stage MF, suggesting the need for larger studies to confirm these findings. The identification of such predictors could enhance the prognostic stratification and guide more tailored therapeutic approaches for MF patients.
摘要：
原发性皮肤淋巴瘤（PCLs），尤其是霉菌病（MF），构成重大的诊断和治疗挑战。这项研究旨在将MF患者的初始组织学特征与病程和生存率相关联。对83例诊断为早期MF的患者进行了一项回顾性前瞻性队列研究，萨格勒布UHC,2003年1月至2012年12月。分析的组织病理学参数包括苔藓样真皮淋巴细胞浸润，Pautrier微脓肿,淋巴细胞异型性.每100个角质形成细胞具有超过30个监护淋巴细胞的患者表现出较差的总体和无进展生存期。此外，那些超过50%的非典型淋巴细胞表现出更快的进展速度。密集的苔藓样皮肤浸润和大量淋巴细胞“饲养者”在诊断后五年内显着增加了死亡风险。这项研究并未完全证实有关大型Pautrier微脓肿的预后价值的假设，但强调了致密苔藓样浸润的重要性。该研究确定了早期MF的新的潜在组织病理学预后因素，这表明需要更大规模的研究来证实这些发现。此类预测因子的识别可以增强预后分层并指导针对MF患者的更量身定制的治疗方法。
