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9 out of 10

Mycosis fungoides which is not true (AIPG 2009)

A It is the most common form of cutaneous lymphoma

B Pautrier’s microabscess

C Indolent course and easily amenable to treatment

D Erythroderma seen and spreads to peripheral circulation

Ans. C

Indolent course and easily amenable to treatment

Mycosis Fungoides

Mycosis fungoides is synonymous with Cutaneous T cell lymphoma. It is the most common form of cutaneous lymphoma.

Clinical presentation and course:

1. Mycosis fungoides has an indolent course.

2. Most affected individuals have disease that remains localized to the skin for many years.

3. It begins on the skin and may involve only the skin for years or decades

4. Presentation is with localized or generalized erythematous / eczematous skin lesions.

5. Skin lesion progress from 'patch' stage to 'plaque stage' to cutaneous 'tumors' stage.

6. Metastasis occurs in advanced stages to:

1. To lymph nodes

2. Peripheral circulation

Sézary syndrome (Erythroderma and Circulating tumor cells)

Seeding of the blood by tumor cells is accompanied by diffuse erythema and scaling of the entire body surface (erythroderma).


Sezary - Lutzner cells

Pautrier Microabscesses

1. Histological hall mark of

2. Mycosis fungoides

3. These are T helper cell (CD4 positive)

Sézary - Lutzner cells characteristically form band like aggregates within the superficial dermis and invade the epidermis as single cells or small clusters called Pautrier's Microabscesses.

Treatment (Mycosis fungoides is not easily amenable to treatment)

1. The treatment of Mycosis fungoides is complex. Even early and aggressive treatment has not been proved to cure or prevent progression of the disease.

2. Cure has been possible with radiotherapy only in rare patients with early stage mycosis fungoides.

3. Most of the treatment for mycosis fungoides are palliative.

4. 4. Other T/T options are – steroid, topical nitrogen mustard & PUVA.

Note: Mycosis fungoides has an indolent course but it is not easily amenable to treatment.

Summary of the more common Lymphoid Neoplasms (Ref. Robbins (Basic Pathology 8th Ed.) Page 448)


Salient Morphology


Precursor B-cell lymphoblastic leukemia/lymphoma

Lymphoblasts with irregular nuclear contours, condensed chromatin, small nucleoli, and scant agranular cytoplasm.

TdT + immature B cells (CD19+, variable expression of other B cell markers)

Precursor T-cell leukemia/ lymphoma

Identical to precursor B-cell lymphoblastic leukemia/lymphoma

TdT+ immature T cells (CD2+, CD7+, variable expression of other T-cell markers)

Small lymphocytic lymphoma/ chronic lymphocytic leukemia

Small resting lymphocytes mixed with variable numbers of larger activated cells; lymph nodes diffusely effaced

CD5+ B cell expressing surface Ig

Follicular lymphoma

Frequent small "cleaved" cells mixed with large cells; growth pattern is usually nodular (follicular).

CD10+ BCL2+ mature B cells that express surface Ig

Mantle cell lymphoma

Small to intermediate-sized irregular lymphocytes growing in a diffuse pattern

CD5 – CD10 – mature B cells with surface Ig

Extranodal marginal zone lymphoma

Variable cell size and differentiation; 40% show plasmacytic differentiation; B cells home to epithelium, creating "lymphoepithelial lesions"

Mature B cells with variable expression of CD10 and surface Ig

Diffuse large B cell lymphoma

Variable; most resemble large germinal center B cells; diffuse growth pattern

Mature B cells with variable expression of CD10 and surface Ig

Burkitt lymphoma

Intermediate-sized round lymphoid cells with several nucleoli; diffuse tissue involvement associated with apoptosis produces a "starry-sky" appearance

Mature CD10+ B cells expressing surface Ig

Plasmacytoma/plasma cell myeloma

Plasma cells in sheets, sometimes with prominent nucleoli or inclusions containing Ig

Terminally differentiated plasma cells containing cytoplasmic Ig

Mycosis fungoides

In most cases, small lymphoid cells with markedly convoluted nuclei; cells often infiltrate the epidermis (Pautrier microabscesses)

CD4+ mature T cells

Peripheral T-cell lymphoma, not otherwise specified (NOS)

Variable; usually a spectrum of small to large lymphoid cells with irregular nuclear contours

Mature T-cell phenotype (CD3+)

Hodgkin lymphoma, nodular sclerosis type

Lacunar Reed-Sternberg cell variants in a mixed inflammatory background; broad sclerotic bands of collagen usually also present

CD15+, CD30+ Reed-Sternberg cells

Hodgkin lymphoma, mixed cellularity type

Frequent classic Reed-Sternberg cells in a mixed inflammatory background

CD15+, CD30+ Reed-Sternberg cells

Hematology Flashcard List

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