1
|
Taleb E, Yélamos O, Ardigo M, Christensen RE, Geller S. Non-invasive Skin Imaging in Cutaneous Lymphomas. Am J Clin Dermatol 2024; 25:79-89. [PMID: 37964050 PMCID: PMC10842086 DOI: 10.1007/s40257-023-00824-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
The diagnosis of cutaneous lymphomas is challenging and requires skin tissue for histology and immunophenotyping using immunohistochemistry and molecular studies. In recent years, the role of non-invasive imaging techniques has been described as part of the clinical assessment of cutaneous lymphoma lesions. Imaging modalities such as dermoscopy, reflectance confocal microscopy (RCM), and high frequency ultrasound (HFUS) have been shown to be very valuable in raising the clinical suspicion for lymphomas of the skin, and in distinguishing cutaneous lymphomas from inflammatory dermatoses such as lupus, psoriasis, or eczema. These non-invasive methods can be used to direct the clinician to the optimal biopsy site to maximize the histopathological results and minimize false negatives. These methods also have a potential place in monitoring treatment response. In this review we present a concise summary of the dermoscopic imaging, RCM, and HFUS features seen in cutaneous T-cell lymphomas (CTCL) and B-cell lymphomas (CBCL).
Collapse
Affiliation(s)
- Eyal Taleb
- Division of Dermatology, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oriol Yélamos
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB, SANT PAU), Barcelona, Spain
| | - Marco Ardigo
- San Gallicano Dermatological Institute IRCCS, Rome, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Rachel E Christensen
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 530 East 74th Street, New York, NY, 10021, USA
| | - Shamir Geller
- Division of Dermatology, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 530 East 74th Street, New York, NY, 10021, USA.
| |
Collapse
|
2
|
Nicolescu AC, Ionescu S, Ancuta I, Popa VT, Lupu M, Soare C, Cozma EC, Voiculescu VM. Subepidermal Low-Echogenic Band-Its Utility in Clinical Practice: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13050970. [PMID: 36900113 PMCID: PMC10000591 DOI: 10.3390/diagnostics13050970] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
High-frequency ultrasonography (HF-USG) is a relatively new imaging method that allows the evaluation in a non-invasive manner of the skin layers and skin appendages. It is a diagnostic tool with increasing usefulness in numerous dermatological pathologies. High reproducibility, non-invasiveness and short diagnostic time make this method an increasingly used tool in dermatological practice. The subepidermal low-echogenic band is a relatively newly described parameter that seems to be a marker not only of intrinsic and extrinsic skin aging, but also of inflammatory processes taking place at the skin level. This systematic review aims to evaluate the role that SLEB has in the diagnosis and monitoring of the treatment of some inflammatory and non-inflammatory dermatological conditions, as well as its utility as a disease marker.
Collapse
Affiliation(s)
| | - Sinziana Ionescu
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Surgery Department, “Prof. Dr. Al. Trestioreanu” Oncology Institute Bucharest, 022328 Bucharest, Romania
| | - Ioan Ancuta
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Rheumatology Department, “Dr. I. Cantacuzino” Clinical Hospital, 020475 Bucharest, Romania
| | - Valentin-Tudor Popa
- Dermatology Department, Center for Morphologic Study of the Skin MORPHODERM, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mihai Lupu
- Department of Dermatology, MEDAS Medical Center, 030447 Bucharest, Romania
| | - Cristina Soare
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Elena-Codruta Cozma
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania
- Pathophysiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence:
| | - Vlad-Mihai Voiculescu
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania
| |
Collapse
|
3
|
Lyu H, Chen XM, Yu GY, Wang HJ, Sun DS, Shi Y, Xie HQ. Sonographic features of secondary involvement of skin and subcutaneous tissues by hematologic malignancies. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1436-1442. [PMID: 36223254 PMCID: PMC9828443 DOI: 10.1002/jcu.23368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To evaluate the sonographic features of secondary involvement of skin and subcutaneous tissues by hematologic malignancies. METHODS A review of the ultrasound and pathology databases yielded 10 cases with 13 skin and subcutaneous tissue lesions secondary to hematologic neoplasms, which were confirmed by pathology. We used ultrasound to assess the number, location, size, depth of involvement, echogenicity, and vascularity of the lesions. RESULTS The study involved five male and five female patients, including four leukemia, two multiple myeloma, and four lymphoma patients. The average age was 45 years (17-66 years). Three patients presented with one lesion, four with two lesions, and three with more than two lesions. All the lesions were located in the trunk and extremities. The lesions ranged from 1.2 to 8.3 cm in size. A total of 10 lesions involved subcutaneous fat tissue. A total of 10 lesions displayed hypoechoic foci within a hyperechoic background, and three appeared hypoechoic, and most of them exhibited abundant vascularity (12 of 13 lesions). CONCLUSIONS Secondary involvement of skin and subcutaneous tissues by hematologic malignancies often present with multiple palpable masses showing the following ultrasound features: (1) subcutaneous fat infiltration, (2) hypoechoic foci with a hyperechoic background, and (3) abundant vascularity.
Collapse
Affiliation(s)
- Heng Lyu
- Department of UltrasoundPeking University Shenzhen HospitalShenzhenChina
| | - Xiang Mei Chen
- Department of UltrasoundPeking University Shenzhen HospitalShenzhenChina
| | - Guang Yin Yu
- Department of PathologyPeking University Shenzhen HospitalShenzhenChina
| | - Hong Jin Wang
- Shenzhen Mindray Bio‐medical Electronics Co. LtdShenzhenChina
| | - De Sheng Sun
- Department of UltrasoundPeking University Shenzhen HospitalShenzhenChina
| | - Yu Shi
- Department of UltrasoundPeking University Shenzhen HospitalShenzhenChina
| | - Hai Qin Xie
- Department of UltrasoundPeking University Shenzhen HospitalShenzhenChina
| |
Collapse
|
4
|
Yazdanparast T, Yazdani K, Ahmad Nasrollahi S, Izadi Firouzabadi L, Humbert P, Khatami A, Kassir M, Firooz A. Biophysical and ultrasonographic changes in early patch/plaque stage of mycosis fungoides, compared with uninvolved skin. Skin Res Technol 2021; 27:1029-1034. [PMID: 33974716 DOI: 10.1111/srt.13053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The goal of this study was evaluation of the skin biophysical properties in early patch/plaque stage of mycosis fungoides (MF) and its comparison with uninvolved skin in order to gain a better understanding of the pathogenesis of diseases. MATERIALS AND METHODS The stratum corneum hydration, transepidermal water loss (TEWL), surface friction, pH, sebum, melanin, erythema, temperature, elasticity parameters (R0, R2, R5), thickness, and echo density of epidermis and dermis were measured on lesions of 21 patients and compared with controls (average measures of uninvolved perilesional and symmetrical skins) by paired sample t test. RESULTS Stratum corneum hydration (P < 0.001) and echo density of dermis (P = 0.044) were significantly lower, whereas pH (P-value = 0.007), erythema (P < 0.001), and melanin content (P = 0.007) were significantly higher in lesions. There was not any significant difference in TEWL, friction index, sebum, temperature, R0, R2, R5, thickness of epidermis and dermis, and echo density of epidermis between lesions and normal skin. CONCLUSION Parapsoriasis/MF lesions are specified by a set of certain changes in biophysical properties which are mainly correlated with histological changes. These sets of alterations may help in noninvasive, early diagnosis of parapsoriasis/MF.
Collapse
Affiliation(s)
- Taraneh Yazdanparast
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Yazdani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Ahmad Nasrollahi
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Izadi Firouzabadi
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Khatami
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Firooz
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.,Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Levy J, Barrett DL, Harris N, Jeong JJ, Yang X, Chen SC. High-frequency ultrasound in clinical dermatology: a review. Ultrasound J 2021; 13:24. [PMID: 33877462 PMCID: PMC8058126 DOI: 10.1186/s13089-021-00222-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/27/2021] [Indexed: 01/18/2023] Open
Abstract
Background Ultrasound was first introduced in clinical dermatology in 1979. Since that time, ultrasound technology has continued to develop along with its popularity and utility. Main text summary Today, high-frequency ultrasound (HFUS), or ultrasound using a frequency of at least 10 megahertz (MHz), allows for high-resolution imaging of the skin from the stratum corneum to the deep fascia. This non-invasive and easy-to-interpret tool allows physicians to assess skin findings in real-time, enabling enhanced diagnostic, management, and surgical capabilities. In this review, we discuss how HFUS fits into the landscape of skin imaging. We provide a brief history of its introduction to dermatology, explain key principles of ultrasonography, and review its use in characterizing normal skin, common neoplasms of the skin, dermatologic diseases and cosmetic dermatology. Conclusion As frequency advancements in ultrasonography continue, the broad applications of this imaging modality will continue to grow. HFUS is a fast, safe and readily available tool that can aid in diagnosing, monitoring and treating dermatologic conditions by providing more objective assessment measures.
Collapse
Affiliation(s)
- Jack Levy
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Devon L Barrett
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nile Harris
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Jiwoong Jason Jeong
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Department of Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Xiaofeng Yang
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Suephy C Chen
- Department of Dermatology, Duke University School of Medicine, Duke Clinic, 40 Duke Medicine Cir, Clinic 3K, Durham, NC, 27710-4000, USA.
| |
Collapse
|
6
|
Polańska A, Jenerowicz D, Paszyńska E, Żaba R, Adamski Z, Dańczak-Pazdrowska A. High-Frequency Ultrasonography-Possibilities and Perspectives of the Use of 20 MHz in Teledermatology. Front Med (Lausanne) 2021; 8:619965. [PMID: 33693015 PMCID: PMC7937737 DOI: 10.3389/fmed.2021.619965] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/11/2021] [Indexed: 12/28/2022] Open
Abstract
High-frequency ultrasonography (HF-USG) is a non-invasive and in vivo method of visualization of the skin and upper part of subcutaneous tissue based on ultrasounds above 20 MHz. Although initially HF-USG was introduced to measure skin thickness, it currently gained widespread acceptance in dermato-oncology, primarily when used to determine skin tumor margins. Moreover, its application in different dermatology fields is known, particularly as a rapidly evolving method in the objective evaluation of the severity of various chronic skin diseases. Among different specialties, teledermatology belongs to leading and continually developing areas of successful telemedicine applications. Various skin conditions are visible to the human eye, which makes them particularly suitable for telemedicine. However, HF-USG enables specialists to look into deeper skin layers, thus extending diagnostic options. On the other hand, teledermatology creates the possibility of sending images for consultation and facilitates the therapeutic decision as HF-USG can be used in an asynchronous store and forward manner. It seems that HF-USG and teledermatology may be regarded as a truly matched pair. The aim of this work is to present current applications of 20-MHz ultrasonography in dermatology, including skin neoplasms and chronic skin diseases. Moreover, the authors aimed to analyze the possibilities of HF-USG use as a valuable tool in teledermatology, especially in diagnosing and monitoring patients suffering from long-lasting skin conditions.
Collapse
Affiliation(s)
- Adriana Polańska
- Department of Dermatology and Venereology, Poznań University of Medical Sciences, Poznań, Poland
| | - Dorota Jenerowicz
- Department of Dermatology, Poznań University of Medical Sciences, Poznań, Poland
| | - Elżbieta Paszyńska
- Department of Integrated Dentistry, Poznań University of Medical Sciences, Poznań, Poland
| | - Ryszard Żaba
- Department of Dermatology and Venereology, Poznań University of Medical Sciences, Poznań, Poland
| | - Zygmunt Adamski
- Department of Dermatology, Poznań University of Medical Sciences, Poznań, Poland
| | | |
Collapse
|
7
|
Wohlmuth-Wieser I, Ramjist JM, Shear N, Alhusayen R. Morphologic Features of Cutaneous T-Cell Lymphomas Using Dermoscopy and High Frequency Ultrasound. J Clin Med 2020; 10:jcm10010017. [PMID: 33374774 PMCID: PMC7795589 DOI: 10.3390/jcm10010017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/16/2020] [Accepted: 12/21/2020] [Indexed: 01/17/2023] Open
Abstract
The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.
Collapse
Affiliation(s)
- Iris Wohlmuth-Wieser
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center, Toronto, ON M4N 3M5, Canada; (N.S.); (R.A.)
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Dermatology and Allergology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
- Correspondence:
| | - Joel M. Ramjist
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada;
| | - Neil Shear
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center, Toronto, ON M4N 3M5, Canada; (N.S.); (R.A.)
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Raed Alhusayen
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center, Toronto, ON M4N 3M5, Canada; (N.S.); (R.A.)
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| |
Collapse
|
8
|
Mikiel D, Polańska A, Żaba R, Adamski Z, Dańczak-Pazdrowska A. High-frequency ultrasonography of the scalp - Comparison of ultrasound and trichoscopic images in healthy individuals. Skin Res Technol 2020; 27:201-207. [PMID: 33128476 DOI: 10.1111/srt.12930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hair loss is a common problem in dermatological patients. Its diagnosis is based on selected non-invasive and invasive tests. Searching for new diagnostic methods, especially non-invasive ones, aims to accelerate the correct diagnosis in the least invasive way possible. The aim of our study was to establish the characteristics of ultrasound images in healthy individuals and to compare them to selected trichoscopic parameters. MATERIALS AND METHODS Eighteen healthy adults (10 women and 8 men) underwent trichoscopy and high-frequency ultrasound (HF-USG) with 20 MHz DermaScan transducer on the parietal region of the scalp. Selected parameters were compared in relation to sex and the research method used. RESULTS HF-USG of the parietal area in all examined patients revealed hyperechogenic entrance echo and less echogenic layer corresponding to the dermis with well-defined hypoechoic follicular structures (FS). The number of hair units in trichoscopy and the number of FS in HF-USG did not differ significantly, while the differences in the studied distances between structures were statistically significant. The width of FS in HF-USG was significantly higher than hair shafts thickness in trichoscopy. CONCLUSIONS HF-USG (20MHz) due to the possibility of visualization of FS can be a valuable complement to the range of non-invasive diagnostic procedures used in evaluation of the scalp.
Collapse
Affiliation(s)
- Dominik Mikiel
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.,Department of Skin Diseases, Provincial Hospital in Poznan, Poznan, Poland
| | - Adriana Polańska
- Department of Dermatology and Venerology, Poznan University Of Medical Sciences, Poznan, Poland
| | - Ryszard Żaba
- Department of Dermatology and Venerology, Poznan University Of Medical Sciences, Poznan, Poland
| | - Zygmunt Adamski
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | | |
Collapse
|
9
|
Niu Z, Wang Y, Zhu Q, Liu J, Liu Y, Jin H. The value of high-frequency ultrasonography in the differential diagnosis of early mycosis fungoides and inflammatory skin diseases: A case-control study. Skin Res Technol 2020; 27:453-460. [PMID: 33112015 DOI: 10.1111/srt.12945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/05/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The clinical manifestations of early mycosis fungoides (eMF) are non-specific and similar to inflammatory skin diseases. High-frequency ultrasonography (HF-US) can show small structure of skin lesions and is helpful to provide information objectively. MATERIALS AND METHODS A case-control study was designed in 62 patients with multiple erythemas and scales, including 18 eMF and 44 age-matched patients with eczema (EC) or psoriasis vulgaris (PsV). The most significant lesions were collected by 50 MHz HF-US. The assessment of ultrasound included epidermal morphology and thickness, infiltration depth, subepidermal low echogenic band (SLEB) boundary and thickness, internal echo, and number of linear acoustic shadows (LAS) behind the epidermis. The ultrasonic characteristics of eMF, EC, and PsV lesions were analyzed. RESULTS Epidermal thickness (P < .001, sensitivity 88.9%, specificity 75.0%) and SLEB thickness (P = 0.006, sensitivity 55.6%, specificity 90.9%) were useful for differential diagnosis of eMF and PsV/EC. When eMF was diagnosed by epidermal thickness < 0.2375 mm, the AUC was 0.845, which had the highest diagnostic efficacy among all ultrasound signs. In addition, compared with eMF and EC, the LAS number of PsV lesions was the highest and statistically significant. CONCLUSION The results showed that HF-US could provide some extra information in identification of eMF, EC, and PsV and has potential clinical value.
Collapse
Affiliation(s)
- ZiHan Niu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - YuKun Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - QingLi Zhu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - YueHua Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - HongZhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
10
|
Wang Y, Niu Z, Liu J, Zhu Q, Liu Z, Liu Y, Jin H. Value of High-Frequency Ultrasound in Accurate Staging of Mycosis Fungoides/Sézary Syndrome. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1927-1937. [PMID: 32319698 DOI: 10.1002/jum.15297] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This study was aimed to assess the ultrasound (US) characteristics of mycosis fungoides (MF)/Sézary syndrome (SS) and explore the value of high-frequency US in accuracy staging for classic mycosis fungoides (cMF). METHODS A prospective study was designed. Twenty-six patients with histopathologically confirmed MF or SS were enrolled to undergo HF-US examinations. Both 50- and 20-MHz US images of the most prominent lesion of each patient were collected by a cutaneous diagnostic US system, and the US characteristics in different stages were analyzed by 2 physicians independently. The Fisher exact test was used for the statistical analysis. RESULTS A total of 26 patients underwent this study, including 23 with cMF, 2 with folliculotropic mycosis fungoides (FMF), and 1 with SS. Among cMF, 16 patients with patches or plaques (the early-stage group) showed a subepidermal low-echogenic band, and only 3 lesions in the plaque stage partially extended to the superficial dermis. Seven patients with tumors (the advanced-stage group) showed lesions that infiltrated to the deep dermis or subcutaneous tissue. The infiltration depth (P < .001), clarity of the boundary (P = .002), and homogeneity of internal echoes (P = .001) were significantly different between the early and advanced stages. Additionally, the 2 FMF lesions and 1 SS lesion had characteristic manifestations, showing a well-defined subepidermal low-echogenic band with patchy hypoechoic regions around the hair follicles in the dermis. CONCLUSIONS High-frequency US can be used to accurately detect the infiltration depth and morphologic features of MF/SS lesions and provide important information for tumor staging of cMF. Additionally, the characteristic US features in FMF and SS might be helpful for diagnosis.
Collapse
Affiliation(s)
- Yukun Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zihan Niu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qingli Zhu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhaorui Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuehua Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongzhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
11
|
Polańska A, Bowszyc‐Dmochowska M, Olek‐Hrab K, Adamski Z, Żaba R, Dańczak‐Pazdrowska A. High‐frequency ultrasonography a new quantitative method in evaluation of skin lymphomas—First comparative study in relation to histopathology. Skin Res Technol 2019; 25:720-724. [DOI: 10.1111/srt.12708] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/26/2019] [Accepted: 04/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Adriana Polańska
- Department of Dermatology and Venereology University of Medical Sciences Poznań Poland
| | | | | | - Zygmunt Adamski
- Department of Dermatology University of Medical Sciences Poznań Poland
| | - Ryszard Żaba
- Department of Dermatology and Venereology University of Medical Sciences Poznań Poland
| | | |
Collapse
|
12
|
Mandava A, Koppula V, Wortsman X, Catalano O, Alfageme F. The clinical value of imaging in primary cutaneous lymphomas: Role of high resolution ultrasound and PET-CT. Br J Radiol 2019; 92:20180904. [PMID: 30608186 DOI: 10.1259/bjr.20180904] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND: Primary cutaneous lymphoma is a rare extranodal non-Hodgkin's lymphoma confined to the skin. The data on the imaging findings of primary cutaneous lymphomas are largely lacking and the current diagnosis is based on clinical and histopathological examination. With the advances in dermatological ultrasound and molecular imaging, newer perspectives in the evaluation of cutaneous lymphomas are available. OBJECTIVE: To review and describe the imaging findings in patient's with the diagnosis of primary cutaneous lymphoma. METHODS: A multicentric, retrospective observational study was undertaken in four countries to review the high resolution ultrasonography (HRUS) and fluorine 18-fludeoxyglucose positron emission tomography-computed tomography (PET-CT) imaging findings. RESULTS: We had 41 patients, Female:Male 1:4.1; mean age, 57 years; range, 13-94 years. High resolution ultrasonography of the primary cutaneous lesions revealed thickening of the dermis in all the cases and the lesions were hypoechoic without any calcifications or central necrosis. The sonographic appearances of the lesions were categorised into focal infiltrative, nodular, pseudonodular, and diffusely infiltrative patterns. Nodular and pseudonodular lesions were predominant in B cell lymphomas, while diffusely infiltrative lesions were more common in T-cell lymphomas. On colour Doppler imaging, the lesions were hypervascular. Whole body 18F-fludeoxyglucose PET-CT imaging of the patients revealed increased uptake of the metabolite in the lesions. CONCLUSION: Sonographic patterns based on high resolution ultrasonography provide early clues to the non-invasive diagnosis of primary cutaneous lymphomas and PET-CT is the recommended modality of imaging for staging and follow-up. ADVANCES IN KNOWLEDGE: High resolution ultrasound with colour Doppler and PET-CT imaging are complimentary to the clinical diagnosis of primary cutaneous lymphomas.
Collapse
Affiliation(s)
- Anitha Mandava
- 1 Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Institute and Research Centre , Hyderabad , India
| | - Veeraiah Koppula
- 1 Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Institute and Research Centre , Hyderabad , India
| | - Ximena Wortsman
- 2 Departments of Dermatology, Faculties of Medicine, University of Chile and Pontifical Catholic University of Chile , Santiago , Chile
| | | | - Fernando Alfageme
- 4 Dermatology Service, Hospital Universitario, Puerta de Hierro, Majadahonda , Madrid , Spain
| |
Collapse
|
13
|
Genovese G, Nazzaro G, Alberti Violetti S, Passoni E, Berti E. Rosacea-like cutaneous localization of small lymphocytic lymphoma unmasked by high-frequency-ultrasound. Skin Res Technol 2018; 24:701-703. [PMID: 29790607 DOI: 10.1111/srt.12586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2018] [Indexed: 11/29/2022]
Affiliation(s)
- G Genovese
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - G Nazzaro
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - S Alberti Violetti
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - E Passoni
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - E Berti
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| |
Collapse
|