Evaluation of provided clinical information on the histopathology request forms and histopathological findings to detect early mycosis fungoides according to ISCL algorithm

Mycosis fungoides (MF) is the most common primary cutaneous lymphoma. Diagnosis of early MF (eMF) is often difficult due to its resemblance of benign dermatoses. The aim of this study was to evaluate the role of provided clinical information on the histopathology request forms for diagnosis of eMF according to the International Society of Cutaneous Lympoma (ISCL) criteria. In this cross-sectional study, 108 patients admitted to Razi Hospital, Tehran, between April 2012 and November 2013, who were biopsied as eMF cases, were recruited. Based on partial application of ISCL algorithm, the checklist of clinical and histopathological findings were scored. Eighty-five (78.7%) patients received maximum total clinical and histopathological scores (4) and their eMF were definitely diagnosed. Sixteen (14.8%) patients received a total score of 3, and suggestive eMF diagnosis was made. Further work up such as immunohistochemistry (IHC) evaluation were recommended. Seven patients (6.5%) received a total score of 2, which did not confirm eMF diagnosis. Follow up was recommended. In 14 (87.5%) of 16 patients who had received a total score of 3, the definite diagnosis of eMF was made according to the results of IHC. They were referred to receive treatment. In 2 patients (12.5%) diagnosis of eMF were not confirmed by IHC. They were recommended to undergo polymerase chain reaction (PCR) evaluation. Many MF cases can be diagnosed in the early stages using a combination of clinical and histopathological criteria.