Mycosis fungoides: Positron emission tomography/computed tomography in staging and monitoring the effect of therapy

Erythrodermic mycosis fungoides: A case report

BACKGROUND

Mycosis fungoides is the most common primary cutaneous T-cell lymphoma, whereas generalized erythroderma is rare. In this report, we describe a case of mycosis fungoides with generalized erythroderma using complete clinical data and [18F]fluoroDglucose positron emission tomography/computed tomography (18F-FDG PET/CT) images.

CASE SUMMARY

Systemic skin redness with desquamation for three years confirmed mycosis fungoides within one month. The patient underwent left axillary lymphadenectomy biopsy; pathological biopsy suggested abnormal T-cell lesions consistent with mycosis fungoides involving lymph nodes. The patient received methotrexate, 5 mg twice weekly, as part of their chemotherapy regimen. Patients January half after discharge, no obvious cause of high fever, left axillary lymph nodes with red heat pain, and rupture entered our hospital for treatment.

CONCLUSION

The 18F-FDG PET/CT is essential for early diagnosis and timely treatment.

Interesting Presentation of Mycosis Fungoides in Staging on F-18 FDG PET/CT

Mycosis fungoides is the major form of primary cutaneous T cell lymphoma. Its staging is based on the percentage of body surface involvement and biopsy-proven extra cutaneous nodal or visceral involvement. Literature shows F-18 FDG accumulation in disease-involved nodes and viscera with non-specific uptake due to co-existing inflammation limits its specificity. We report an interesting case of mycosis fungoides with bilateral upper limb edema and share its findings on F-18 FDG PET/CT.

Mycosis fungoides staged by 18F-flurodeoxyglucose positron emission tomography/computed tomography: Case report and review of literature

INTRODUCTION

Mycosis fungoides is a kind of malignant lymphoma arising from T cells, but primarily occurs in skin, and it is the most common type of cutaneous lymphoma. Mycosis fungoides (MF) is a rare non-Hodgkin lymphoma but the most common type of primary cutaneous T-cell lymphomas. Because of unknown etiology and mechanism, and lack of typical clinical and histophysiological manifestations, the final diagnosis of MF is currently dependent on pathology and immunohistochemistry. Subsequently, tumor staging is very important. Different approaches would be taken according to varying degrees of cutaneous and extracutaneous lesions. Computed tomography (CT) scan has been chosen to stage tumors customarily. However, CT could only provide morphological information and analyze lymphadenopathy by the size criteria. F-flurodeoxyglucose positron emission tomography/computed tomography (PET/CT) could provide morphological information and metabolic conditions simultaneously, which is helpful to locate and stage lesion.

CONCLUSION

F-flurodeoxyglucose PET/CT could identify cutaneous and extracutaneous lesions in patients with MF. It could provide the range of lesions and biopsy target.

The utility of positron emission tomography with and without computed tomography in patients with nonmelanoma skin cancer

Combined positron emission tomography (PET) and computed tomography (CT) scans are widely used in the staging and monitoring of most malignancies. The differential for PET-positive cutaneous lesions includes primary skin cancers, infections, cutaneous metastases from distant malignancies, and benign neoplasms. In dermatology, PET/CT scans have been most widely studied in patients with melanoma and Merkel cell carcinoma. The role of PET/CT scans in the management of other cutaneous malignancies is less clear, but it has shown great promise in the management of patients with squamous cell carcinoma and cutaneous lymphoma. This review seeks to address the usefulness of PET/CT scans in nonmelanoma skin cancer and to provide guidance regarding the management of patients with incidental PET-positive nodules. Currently, there is limited experience with PET/CT scans for staging and monitoring of non-head and neck metastatic basal cell and squamous cell carcinomas, and results show limited sensitivity and specificity. We also address the evidence for management of an incidental PET-positive cutaneous nodule and recommend obtaining a biopsy specimen in patients with a known noncutaneous malignancy, a history of primary skin cancer, or a high risk of either cutaneous or noncutaneous malignancy.