Original ArticleHistopathologic Features of Early (Patch) Lesions of Mycosis Fungoides A Morphologic Study on 745 Biopsy Specimens From 427 PatientsMassone, Cesare MD*†; Kodama, Kazuo MD*‡; Kerl, Helmut MD*; Cerroni, Lorenzo MD*Author Information From the *Department of Dermatology, Medical University of Graz, Graz, Austria; †DiSEM, Section of Dermatology, University of Genoa, Genoa, Italy; and ‡Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. Reprints: Lorenzo Cerroni, MD, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036 Graz, Austria (e-mail: [email protected]). The American Journal of Surgical Pathology: April 2005 - Volume 29 - Issue 4 - p 550-560 doi: 10.1097/01.pas.0000153121.57515.c6 Buy Metrics Abstract The histologic diagnosis of early mycosis fungoides (MF) is one of the most vexing problems in dermatopathology. We reviewed the histopathologic features of 745 biopsy specimens from 427 patients (male:female = 277:150; median age, 52 years; range, 3-95 years) with early (patch) lesions of MF collected from the lymphoma database of the Department of Dermatology of the Medical University of Graz (Austria). In all patients, the diagnosis was established by clinicopathologic correlation. The most common histopathologic pattern consisted of a band-like or patchy lichenoid infiltrate admixed with coarse bundles of collagen in the superficial dermis. Epidermotropism of lymphocytes was observed in most cases in one or more forms (single lymphocyte epidermotropism, 22%; basilar lymphocytes, 23%; Pautrier's microabscesses, 19%; “haloed” lymphocytes, 40%; disproportionate exocytosis, 17%; pagetoid epidermotropism, 3%). In 4% of cases, epidermotropism was completely missing. Atypical lymphocytes were present only in 9% of cases. Features of interface dermatitis were observed in 59% of cases. Other unusual findings were the presence of necrotic keratinocytes (23%), melanophages (8%), and extravasated erythrocytes (4%). In 28 patients, two or more biopsies taken on the same day at different body sites showed different histopathologic aspects, underlying the protean features of MF even in a single patient at a given time. Our study expands previous observations on histopathologic features of early lesions of MF. Although sometimes the histopathologic features are not diagnostic, they should be considered consistent with MF and do not rule out the diagnosis. © 2005 Lippincott Williams & Wilkins, Inc.