Mycosis Fungoides (Cutaneous T-Cell Lymphoma): 5-Minute Pathology Pearls
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- Опубликовано: 23 янв 2019
- A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL). In its early patch stage, MF can be difficult to distinguish from chronic spongiotic dermatitis and other inflammatory skin diseases. This video discusses the basic features and some pearls for how I approach this tricky diagnosis in my practice. This is just a brief introduction to a complex topic. I could easily spend an hour talking about mycosis fungoides (maybe I'll make an extended video in future...if you would like to see that, please let me know in the comments). Excerpted from my dermpath basics 4 video for my 5-Minute Pathology Pearls video series.
Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: bit.ly/2Te2haB
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
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For contrast, take a look at this rare variant of MF: Folliculotropic Mycosis Fungoides & Follicular Mucinosis. Digital slides: kikoxp.com/posts/2866/. Also, a complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Thank you so much Dr. Gardner for making these videos. They are very helpul. I appreciate your dedication.
These Videos are Gem. Thank you so much!
Please make a video on approach to cutaneous lymphoma , thanks and keep up the good work !
Thank you so much doctor for this presentation 🌹
I've watched several of your videos already. I am an MS3 interested in Derm doing a path rotation and I'm going to recommend your videos to other students. Well done and nicely compliments and solidifies what I read in Lever's. Thank you
So glad to hear it! I have a dermpath for beginners playlist here: ruclips.net/p/PLkuwOd2JcINMNFdctQNCHISf83xPWTsO2. I also have a Survival Guide to Dermatopathology book coming out in August: www.innovativepathologypress.com/product-page/survival-guide-to-dermatopathology.
great as always! wud love to hv a detailed one if possible please..
Great job Jerad. This is not easy to teach. I tried doing it on a Facebook post. It ended up being a short chapter.
Great, keep it up!
thanks, I would like to see MORE
Please another video for mycosis fungoids and differential diagnosis
Dr Gerald thank very much
For contrast, take a look at this rare variant of MF: Folliculotropic Mycosis Fungoides & Follicular Mucinosis. Digital slides: kikoxp.com/posts/2866/.
I have this on my inner thigh. Confirmed by two different biopsy’s. The specialist gave me steroids. I asked how long do I need to use it. They said 10years.
I’ve been using for a year and the colour has changed but absolutely no changes for the better.
Sir, can you give brief overview of cutaneous pseudolymphoma. Please..
Thank you.
Mycosis Fungoides is bad news for sure.the problem is most of the information is based on the 1a stage with the old adage 'you will die with it not of it'.i had a very close shave with misdiagnosed stage 2b Mycosis Fungoides misdiagnosed as ezecma, then psoriasis and when the tumours came ORF, and I ended up losing a finger and the use of a thumb to it.the skin is very prone to infection from it as it has the added benefit of destroying the skin surface and suppressing the immune system too....and it's fairly obvious what that combination could lead to!
Thankfully most MF I see is early patch stage and has a great prognosis but as you said more advanced disease can be very serious. Sadly I’ve seen quite a few advanced tumor stage MF cases too. I’m so sorry to hear of the difficulties you’ve been through but I thank you for sharing your experiences here for us to learn from. Best wishes for good health.
Need to found a video about sptcl
This is really hard to leave with! My skin goes crazy every time if is not one thing is another.. and I feel that my doctors is everywhere to the point I get seen by students them she comes in and it goes on and on… do I have to be careful on other things beside this does this advance with them years? I take methotrexate 2.5mg every Thursday. But they toll me this is for life
WHAT ABOUT CD3? IS IT USUALLY PRESENT OR MAY BE LOST?
I had t cell lymphoma Mycosis Fungoides. Lesion was on scalp..didnt spread & am fine now. My Oncologist said it'll probably come back eventually.
Fab video! Excellent quality sound and micrographics. Path resident from Scotland here. Would love to see a more in depth video on mycosis fungoides :D if you have the material, the evolution from patch to plaque to erythroderma/sezary syndrome would be very interesting from a patient that has required follow-up biopsies.
Good idea! I’ll see if I can do something like that in future.
Good idea! I’ll see if I can do something like that in future.
Please do a full video on clinical, path, treatment 🙏
I am waiting to get seen by a dermatologist in next couple of weeks and have single plaque like lesion about 4cm diameter on my Lower back, is quite itchy also , was referred by a specialist in mole removal who said he didn't know what I had and said they found t cells in the lesion biopsy, am worried could be kind of mycosis fungoides but only have it in one area as stated above
How did things turn out for you? I have a suspect patch on my inner thigh above my knee, only one about 3 cm in diameter also.
@teddyjackson1902 get to a doctor/dermatologist ASAP and get sample of tissue, my doctor removed most of lesion which was t cell lymphoma and i used elecon steroid cream since on it and perfect. Got bloods checked aswell and all OK. Don't wait get to doc now!
Is the only way to identify MF via skin biopsy? Hypothetically, if a person presents at an early stage physically, but is experiencing systemic symptoms- does that mean we could do a flow cytometry blood test. Will it be seen in the blood? How do blood staging and the CTCL staging overlap or are they separate?
Wanted to bump this question because I saw you just posted! 🤞🏻✨
Do you ever see a positive T-cell gene rearrangement, and it is not T-cell lymphoma/MF? My colleague showed me a case where he requested TCGR in hopes he could exclude MF, but it was positive. Great video Jerad, and thanks!
Oh yes. That can happen. Reactive processes can have clonality sometimes. And lymphomas sometimes test negative for clonality. No test is perfect!
Many Thanks !
Can't B cells be found in Mycosis Fungoides?
There may be scattered reactive B cells in the background dermis, but the Neoplastic cells are always T cells in MF. That said, I have seen one case of methotrexate associated EBV driven B cell proliferation that had epidermotropic atypical B cells. To my recollection, that’s the only time that I’ve seen B cells in the epidermis. But I’m not a hemepath expert...perhaps there are other rare entities I’m not familiar with.
@@JMGardnerMD Thank you !
In my case, there are small clusters of cd20+ B cells scattered around. But all in the dermis.
I have had a scaly itchy red rash on my face that comes back once a month for the past year and a half..I think I have this! I have been to 7 doctors and no one is catching this..and I am a a medical assistant..Can you recommend a doctor in the Baltimore Md or Pennsylvania area please to get a diagnosis
I'm so sorry to hear of your issue. Have you seen a board certified dermatologist? Have they done a biopsy?
@@JMGardnerMD yes i jave seen several derms n no they didnt do a biopsy but next one i go to i will demand to get a biopsy
Sir I'm frm India and I would like to know... If one prsn has MF...then could it be seen in CBC (WBC count)??
is the WBC count increases or decreases or same (as bfr we gt MF)..
Plz sir resolve this query...!!
Its so helpful when one introduces where in the world wide web they are !! So many on here just assume everyone is in the same country- smh
Do they have acne on face?
** Hypotheses...
Psychoncology....does face looking good promote acne to go out of face....
20 years...puberty....
Or cancer at old age?
My fungal infection has gone head to toe for five years. Im disabled in pain in Western USA without knowledgeable help or labs. Acne is indeed where it starts
"Mycosis Fungoides" has to be the grandest medical misnomer in medical nomenclature unless "Mongoloid" (Currently called Down's Syndrome) is considered. Lol
Fettuccine ? Really funny listening to it
Magyarul szeretnem
Mycelium, all fungus produce Mycelium.
Mycosis fungoides is not fungus. It is lymphoma.
@@JMGardnerMD Interesting because wiki has it described as a fungi. "Mycosis" A Fungal infection, also known as mycosis, is a disease caused by fungi. Different types are traditionally divided according to the part of the body affected; superficial, subcutaneous, and systemic. For people looking for help amongst idiot PAs (cant even find a real MD) the struggle is Real !