Original articleA case-control study of clinicopathologic features, prognosis, and therapeutic responses in patients with granulomatous mycosis fungoides
Section snippets
Patient selection
After the approval of the institutional review board, a retrospective chart review was performed, which identified 430 patients with confirmed diagnosis of MF seen between 1981 and 2012. Patients were classified according to revised criteria proposed by the International Society for Cutaneous Lymphomas (ISCL) and EORTC.23 Pathology reports of skin biopsy specimens were screened for the terms “granulomatous” and “histiocytic” infiltrate. We identified 101 patients as possible candidates.
Patient characteristics
In all, 27 patients with GMF were identified representing 6.3% of the total number of patients with MF at our center (Table I). Most patients with GMF were white, presented with a median age of 56 years (range 25-83), and had early-stage IA to IIA disease (70%). The interval from visible symptom onset to MF diagnosis was longer in the GMF group (mean 8.0 years) compared with the control group (mean 4.3 years, P = .04). Second malignancies developed in 44% of patients (12 of 27) with GMF
Discussion
To our knowledge, our retrospective case-case study encompasses the largest number of GMF cases to date and is the first study to analyze relative frequency, prognosis, and treatment responses. Previous studies have found an incidence of 1.6% to 1.8% of granulomatous infiltrates out of all cases of either primary or secondary cutaneous lymphoma,4, 5 but the relative frequency compared with classic MF has never been assessed to our knowledge. We observed a distinct granulomatous pattern in 6.3%
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The first 2 authors contributed equally to this article.
Funding sources: None.
Disclosure: Dr Horwitz has received research grants from Celgene, Allos, Seattle Gen, Infinity Pharmaceuticals, and Kyowa Hakko Kirin. He has consulted for Celgene, Allos, Seattle Gen, Bristol-Myers Squibb, Genzyme, Kyowa Hakko Kirin Pharma, and Johnson & Johnson. Ms Li, and Drs Pulitzer, Myskowski, Dusza, Moskowitz, and Querfeld have no conflicts of interest to declare.