PubMed1984
In this paper are reported the different histological variants of Mycosis Fungoïdes (M.F.) observed in 48 lymph node positive biopsies providing from 98 lymph nodes obtained from 94 patients with M.F. A partial destruction of the lymphoïd architecture was required for attesting M.F. involvement. The remaining 50 lymph nodes demonstrated dermopathic non specific lesions. A partial lymph node involvement is often observed with a persistent sinusal pattern and residual germinative follicles (39 from 48 cases or 80%). The tumoral infiltration begins in the deep cortex and in the interfollicular areas. Some reactive lesions of dermopathic lymphadenopathy are frequently associated. The main histological feature is the cellular pleomorphism. Nevertheless 4 cytological variants may be described according to the predominant proliferating cells: a small cell variant, a large cell variant, a mixed cell variant comprising an equivalent proportion of small medium and large-sized cells, an immunoblastic variant with majority of immunoblasts and some Sternberg-like tumoral cells. Any form may be associated with granuloma which increase polymorphism. In some histological variants, so-called Lutzner cells are numerous and facilitate the diagnosis of epidermotropic malignant T lymphoma. Nevertheless, some cases may be discussed with centrocytic or centroblastic centrocytic lymphomas, with Pinkus multilobulated T lymphoma or with convoluted lymphoblastic lymphoma. More difficult is the distinction from Lennert T - zone lymphomas and from adult T-cell lymphoma/leukemia described in Japan. The immunoblastic variant may be mistaken with some high-grade malignant non-Hodgkin lymphoma, with an angio-immunoblastic lymphadenopathy, even with a metastatic carcinoma. The evidence of granuloma with numerous eosinophiles frequently observed in the Hodgkin-like variant is a cause of confusion with Hodgkin's disease. A good help would be supplied by the discover of some Lutzner cells among the granuloma. No correlation was found between these histological variants and the M.F. evolution. Evidence of reactive inflammatory cells do not interfere with the prognosis.