Mycosis fungoides with spongiosis: a case report.
Case report
Chemotherapy
Mycosis fungoides
Ocean Road Cancer Institute
Total skin electron beam radiotherapy
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
03 Nov 2023
03 Nov 2023
Historique:
received:
17
07
2023
accepted:
20
09
2023
medline:
6
11
2023
pubmed:
3
11
2023
entrez:
3
11
2023
Statut:
epublish
Résumé
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL). CTCL are an uncommon, heterogeneous group of non-Hodgkin lymphomas (NHLs) of T- and B-cell origin where the skin is the primary organ of involvement. It is characterized by malignant CD4 We are reporting a case of a 31-year-old male of African origin who self-referred to our oncology center with a 4-year history of skin rashes throughout the body, which was unresponsive to topical steroid treatment. The biopsy was taken, and the patient was diagnosed with MF CD 3 positive with spongiosis. The patient was treated with radiotherapy, whereby he received low dose total skin electron beam therapy (TSEBT) 12 Gy in 3 fractions at a daily dose of 4 Gy, followed by maintenance therapy of low dose Methotrexate and attained an excellent therapeutic response. Spongiosis is an infrequent presentation of MF. Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with MF, which could be administered safely multiple times during a patient's disease with an acceptable toxicity profile. Lack of tendency to perform skin biopsies and cost constraints in assessing multiple immunophenotypic markers lead to missing the diagnosis. Diagnosis and treatment of MF in resource-limited countries is challenging.
Sections du résumé
BACKGROUND
BACKGROUND
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL). CTCL are an uncommon, heterogeneous group of non-Hodgkin lymphomas (NHLs) of T- and B-cell origin where the skin is the primary organ of involvement. It is characterized by malignant CD4
CASE DESCRIPTION
METHODS
We are reporting a case of a 31-year-old male of African origin who self-referred to our oncology center with a 4-year history of skin rashes throughout the body, which was unresponsive to topical steroid treatment. The biopsy was taken, and the patient was diagnosed with MF CD 3 positive with spongiosis. The patient was treated with radiotherapy, whereby he received low dose total skin electron beam therapy (TSEBT) 12 Gy in 3 fractions at a daily dose of 4 Gy, followed by maintenance therapy of low dose Methotrexate and attained an excellent therapeutic response.
CONCLUSION
CONCLUSIONS
Spongiosis is an infrequent presentation of MF. Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with MF, which could be administered safely multiple times during a patient's disease with an acceptable toxicity profile. Lack of tendency to perform skin biopsies and cost constraints in assessing multiple immunophenotypic markers lead to missing the diagnosis. Diagnosis and treatment of MF in resource-limited countries is challenging.
Identifiants
pubmed: 37919795
doi: 10.1186/s13256-023-04188-2
pii: 10.1186/s13256-023-04188-2
pmc: PMC10623773
doi:
Substances chimiques
Methotrexate
YL5FZ2Y5U1
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
458Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Br J Haematol. 1991 Nov;79(3):428-37
pubmed: 1751370
Crit Rev Oncol Hematol. 2008 Feb;65(2):172-82
pubmed: 17950613
Arch Dermatol. 2008 Jun;144(6):727-33
pubmed: 18559761
S Afr Med J. 2010 Nov 09;100(11):728-33
pubmed: 21081025
Diagnostics (Basel). 2021 Sep 19;11(9):
pubmed: 34574062
Rep Pract Oncol Radiother. 2013 Jun 17;19(2):120-34
pubmed: 24936331
Leukemia. 1998 Apr;12(4):578-85
pubmed: 9557617
Int J Radiat Oncol Biol Phys. 1995 Jul 30;32(5):1445-9
pubmed: 7635786
J Am Acad Dermatol. 2003 Nov;49(5):873-8
pubmed: 14576667
Proc Natl Acad Sci U S A. 1980 Dec;77(12):7415-9
pubmed: 6261256
Pan Afr Med J. 2019 Apr 17;33:227
pubmed: 31692791
Ann Oncol. 2017 Oct 01;28(10):2517-2525
pubmed: 28961843
J Cutan Pathol. 2019 Sep;46(9):645-652
pubmed: 30989664
Case Rep Dermatol Med. 2020 Mar 24;2020:4216098
pubmed: 32274222
J Am Acad Dermatol. 2015 Feb;72(2):286-92
pubmed: 25476993
Postepy Dermatol Alergol. 2023 Feb;40(1):159-164
pubmed: 36909908
Blood. 2008 Oct 15;112(8):3082-7
pubmed: 18647960
Int J Radiat Oncol Biol Phys. 1983 Oct;9(10):1477-80
pubmed: 6195138
Int J Dermatol. 2020 Mar;59(3):352-358
pubmed: 31647120
Front Microbiol. 2012 Nov 15;3:388
pubmed: 23162541
Clin Transl Radiat Oncol. 2022 Jan 18;33:77-82
pubmed: 35106383
Br J Dermatol. 2017 Jun;176(6):1653-1656
pubmed: 27529394
Blood. 2010 Jun 3;115(22):4337-43
pubmed: 20348391
Vox Sang. 1995;69(1):84
pubmed: 7483504
An Bras Dermatol. 2012 Nov-Dec;87(6):817-28; quiz 829-30
pubmed: 23197199
Clin Lymphoma Myeloma. 2006 Jul;7(1):51-8
pubmed: 16879770
Clin Dermatol. 2013 Jul-Aug;31(4):423-431
pubmed: 23806159
J Natl Compr Canc Netw. 2013 Mar 1;11(3):275-280
pubmed: 23486453
Dermatol Ther. 2003;16(4):347-54
pubmed: 14686978
Eur J Cancer. 2021 Jan;142:38-47
pubmed: 33217680
J Am Acad Dermatol. 2002 Aug;47(2):191-7
pubmed: 12140464
Exp Ther Med. 2021 Nov;22(5):1334
pubmed: 34630688
Indian J Dermatol Venereol Leprol. 2015 Mar-Apr;81(2):124-35
pubmed: 25751327
Trop Geogr Med. 1991 Jul;43(3):317-22
pubmed: 1816671
Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):109-15
pubmed: 9422565
J Am Acad Dermatol. 2021 Mar;84(3):615-623
pubmed: 32428610
Arch Dermatol. 1998 Aug;134(8):949-54
pubmed: 9722724
J Cutan Med Surg. 2016 May;20(3):244-8
pubmed: 26742957
Am J Hematol. 2023 Jan;98(1):193-209
pubmed: 36226409