Clinical Analysis Of 21 Cases Of Mycosis Fungoides

Backgroundand purpose:Mycosis fungoides(mycosis fungoides,MF)isa cutaneous T celllymphoma(CTCL)the most commontype,accounting for about 50%,which has a low malignant.The natural course of the disease up to 20-30 years,involving the elderly,both men and women,the incudence ratio(1.6-2.0): 1.The typical mycosisfungoide,experienced erythema stage,plaque stage to the tumor stage up to several decades.The clinical and pathological features of mycosis fungoides is diverse,lack of specific performance,it is difficult to diagnose and currently untreatable.At present,for the early stage of mycosis fungoides,the use of skin targeted therapy combined immune regulation therapy rather than systemic chemotherapy,advanced mycosis fungoide is more chemotherapy.Objective to analyze the clinical data of hospitalized patients with MF first diagnosed in the First Affiliated Hospital of Dalian Medical University,and to provide a help for theearly diagnosis and treatment.Methods:To summarize the clinical data of 21 patients diagnosed with MF hospitalized from the First Affiliated Hospital of Dalian Medical University from 2011 to 2016,including age,sex,onset time,rash distribution,histopathology,immunohistochemistry,routine laboratory test and examination,Diagnosed before diagnosis,treatment and so on.Result:In 21 patients with MF,male to female ratio is 1.625:1,25 to 77-year-old age at diagnosis,an average of 55.38 ± 15.86 years of age,time from onset to diagnosis,the shortest one month,the longest 10 years.The average duration is 33.76 months.In 21 patients with MF,erythema stage 6 cases,histopathology is mainly manifested as shallow dermis,a small amount of lymphocytes around the blood vessels infiltration,cells without atypia,a single nuclear cell pro-epidermis.15 cases of plaque stage,the main manifestations of the performance of the dermis showed more dense lymphocyte infiltration,part of the cells into the epidermis,of which 4 cases can be seen Pautrier micro abscess.All patients were confirmed to be T-cell lymphoma.21 cases of MF patients were diagnosed with 10 misdiagnosed as other diseases,misdiagnosis rate was 47.62%.Common symptoms are mainly itching,15 patients with varying degrees of itching,of which 1 case of itching,the incidence of 71.43%.16 patients withlymphadenopathy,enlargement of axillary lymph nodes and groin lymph node is more common.21 cases of blood tests,2 cases of white blood cells decreased significantly,2 cases of Sézary cells can be seen,respectively1% Sézary cells and 2% Sézary cells.10 patients with blood lactate dehydrogenase,?2 microglobulin,2 cases of lactate dehydrogenase significantly increased with ?2 microglobulin increased,1 case of lactate dehydrogenase increased,1 case of ?2 microglobulin high.Our hospital mainly to skin targeted therapy combined with biological response modulatorof the main rule.The skin targeted therapyincluded hormonetherapy,phototherapy,acitretin treatment.The biological response modulatorsincluded interferon and thymopentin.After comprehensive treatment,4 cases were complete remission(19.05%),8 cases of partial remission(38.10%),the total effective rate was 57.15%,and the remianing patients were improved in different degrees.Conclusions:1.Early mycosis fungoides plaster lesions varied,no specificity,likely to cause clinical misdiagnosis and missed diagnosis.The need for clinicians to increase vigilance,especially the long course.The general treatment is not ideal,it needs many times pathological biopsy,for continuous section observation,and closely combined with histopathology,immunohistochemistry and T cell gene rearrangement,which can early diagnose and early treat.2.MF is currently no radical cure,the main purpose is to relieve symptoms,control the disease,improve the survival rate of patients.The mian rule of early MF are skin-targeted therapy(hormonetherapy,phototherapy,acitretin)combined with biological response modulators(interferon,thymopentin),which have the higher efficiency,and better prognosis of patients.Extremely individual cases of generalized plaque with erosion disease progress quickly,the prognosis is poor.