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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 29 Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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Mycosis Fungoides
picture-1
  Report Record
Go to records July 2010

User Feedback


Admin_Dermpath

Admin_Dermpath 1,217

Posted

Phillip McKee - Overseas consultations (USA) Wrote:

The final diagnosis is mycosis fungoides

Submitted on 20/07/2010 23:10
________________________________________
Phillip McKee - Overseas consultations (USA) Wrote:

I think that this site is gaining strength day by day. The more interactive it becomes the better.

Submitted on 20/07/2010 18:37
________________________________________
JARAMILLO Clara - (Paris (France)) Wrote:

Mycosis Fungoides

Submitted on 20/07/2010 17:15
________________________________________
Phillip McKee - Overseas consultation (USA) Wrote:

Good morning all. You are all doing very well. It is exceedingly important to perform appropriate immunohistochemistry in a case such as this and the clinical information is critical. As mentioned above, there are many conditions that can mimic mycosis fungoides. It is also very important to remember that adverse drug reactions may look exactly like mycosis fungoides. Phillip

Submitted on 20/07/2010 16:56
________________________________________
Iskander Chaudhry - Central Manchester (Manchester UK) Wrote:

I would also go for Mycosis Fungoides and I think the 'string of pearls' sign is evident. The online course should be alive in the next few weeks as Dr Mckee has completed the set and currently the online company is testing the interactive platform. I hope to update you in the coming weeks. Thank you for expressing interest in the project.

Submitted on 20/07/2010 16:45
________________________________________
Wayne Grayson - (Johannesburg, South Africa) Wrote:

Atypical epidermotropic lymphoid infiltrate, consistent with mycosis fungoides. There is, however, a differential diagnosis to consider (e.g. other epidermotropic cutaneous lymphomas, lymphomatoid contact dermatitis, lymphomatoid drug eruption, etc.), so careful clinico-pathological correlation is essential.

Submitted on 20/07/2010 16:43
________________________________________
Donald M. - (USA) Wrote:

Mycosis fungoides. Pautrier's microabscess - classical. Beautiful image Dr McKee - wonderful cases. When will your online course be up and running? Happy to subscribe.

Submitted on 20/07/2010 16:36
________________________________________
Miah Singh - (UK) Wrote:

Sorry I have been away. Atypical lymphoid cells in keeping with mycosis fungoidies

Submitted on 20/07/2010 15:17
________________________________________
Jonathan S. - (UK) Wrote:

MF patch stage

Submitted on 20/07/2010 15:13
________________________________________
CES - (UK) Wrote:

Interesting case. I would also go for mycosis fungoides, but other epidermotropic lymphoid infiltrates would come into the differential including Berti's lymphoma. I think there is enough atypia to exclude inflammatory conditions particularly with the lack of reaction to the surrounding epidermis.

Submitted on 20/07/2010 14:32
________________________________________
Richard Carr - Warwick (UK) Wrote:

Epidermotropic lymphocytic infiltrate c/w MF but any number of other cutaneous and extra-cutaneous lymphoprolfierations can show epidermotropism and some lesions in the hinterland (pityriasis lichenoides chronica) and some benign dermatoses (notably lichen sclerosus, drugs reactions etc etc). MF requires a history (of longstanding patches/plaques in the absence of a relationship to any drugs) and the diagnosis can only be suggested with caveats in the absence of a history. I always find atypia difficult at the best of times and often ask for a thin section and look under oil for the highly convoluted cells. All that said it is probably MF!

Submitted on 20/07/2010 10:03
________________________________________
Naglaa Nabil El Mongy - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Mycosis fungoides. I am a beginer, and I found that your site is very valuable for learning. Thank you Prof.McKee.

Submitted on 20/07/2010 08:57
________________________________________
marwa fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Mycosis Fungoides,nice image

Submitted on 20/07/2010 08:14
________________________________________
Eman El-Nabarawy - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt) Wrote:

Mycosis fungoides.

Submitted on 20/07/2010 05:07
________________________________________
RRestrepo - UPB (Mdlln/Col) Wrote:

Mycosis Fungoides

Submitted on 20/07/2010 00:43
________________________________________
Marcela Saeb Lima - MSL Dermatopato (Mexico City) Wrote:

Beautiful mycosis fungoides

Submitted on 20/07/2010 00:34
________________________________________
Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Mycosis Fungoides

Submitted on 20/07/2010 00:25
________________________________________
Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Atypical lymphocytes surrounded with clear haloes are seen in collections within the epidermis (Pautrier microabscesses). Haphazardly arranged wiry collagen bundles in papillary dermis with dermal lymphocytic infiltrate. Diagnosis: Mycosis Fungoides (Primary cutaneous epidermotropic TCL).

Submitted on 20/07/2010 00:09
________________________________________

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Admin_Dermpath

Admin_Dermpath 1,217

Posted

Phillip McKee - Overseas consultations (USA) Wrote:

The final diagnosis is mycosis fungoides

Submitted on 20/07/2010 23:10
________________________________________
Phillip McKee - Overseas consultations (USA) Wrote:

I think that this site is gaining strength day by day. The more interactive it becomes the better.

Submitted on 20/07/2010 18:37
________________________________________
JARAMILLO Clara - (Paris (France)) Wrote:

Mycosis Fungoides

Submitted on 20/07/2010 17:15
________________________________________
Phillip McKee - Overseas consultation (USA) Wrote:

Good morning all. You are all doing very well. It is exceedingly important to perform appropriate immunohistochemistry in a case such as this and the clinical information is critical. As mentioned above, there are many conditions that can mimic mycosis fungoides. It is also very important to remember that adverse drug reactions may look exactly like mycosis fungoides. Phillip

Submitted on 20/07/2010 16:56
________________________________________
Iskander Chaudhry - Central Manchester (Manchester UK) Wrote:

I would also go for Mycosis Fungoides and I think the 'string of pearls' sign is evident. The online course should be alive in the next few weeks as Dr Mckee has completed the set and currently the online company is testing the interactive platform. I hope to update you in the coming weeks. Thank you for expressing interest in the project.

Submitted on 20/07/2010 16:45
________________________________________
Wayne Grayson - (Johannesburg, South Africa) Wrote:

Atypical epidermotropic lymphoid infiltrate, consistent with mycosis fungoides. There is, however, a differential diagnosis to consider (e.g. other epidermotropic cutaneous lymphomas, lymphomatoid contact dermatitis, lymphomatoid drug eruption, etc.), so careful clinico-pathological correlation is essential.

Submitted on 20/07/2010 16:43
________________________________________
Donald M. - (USA) Wrote:

Mycosis fungoides. Pautrier's microabscess - classical. Beautiful image Dr McKee - wonderful cases. When will your online course be up and running? Happy to subscribe.

Submitted on 20/07/2010 16:36
________________________________________
Miah Singh - (UK) Wrote:

Sorry I have been away. Atypical lymphoid cells in keeping with mycosis fungoidies

Submitted on 20/07/2010 15:17
________________________________________
Jonathan S. - (UK) Wrote:

MF patch stage

Submitted on 20/07/2010 15:13
________________________________________
CES - (UK) Wrote:

Interesting case. I would also go for mycosis fungoides, but other epidermotropic lymphoid infiltrates would come into the differential including Berti's lymphoma. I think there is enough atypia to exclude inflammatory conditions particularly with the lack of reaction to the surrounding epidermis.

Submitted on 20/07/2010 14:32
________________________________________
Richard Carr - Warwick (UK) Wrote:

Epidermotropic lymphocytic infiltrate c/w MF but any number of other cutaneous and extra-cutaneous lymphoprolfierations can show epidermotropism and some lesions in the hinterland (pityriasis lichenoides chronica) and some benign dermatoses (notably lichen sclerosus, drugs reactions etc etc). MF requires a history (of longstanding patches/plaques in the absence of a relationship to any drugs) and the diagnosis can only be suggested with caveats in the absence of a history. I always find atypia difficult at the best of times and often ask for a thin section and look under oil for the highly convoluted cells. All that said it is probably MF!

Submitted on 20/07/2010 10:03
________________________________________
Naglaa Nabil El Mongy - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Mycosis fungoides. I am a beginer, and I found that your site is very valuable for learning. Thank you Prof.McKee.

Submitted on 20/07/2010 08:57
________________________________________
marwa fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Mycosis Fungoides,nice image

Submitted on 20/07/2010 08:14
________________________________________
Eman El-Nabarawy - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt) Wrote:

Mycosis fungoides.

Submitted on 20/07/2010 05:07
________________________________________
RRestrepo - UPB (Mdlln/Col) Wrote:

Mycosis Fungoides

Submitted on 20/07/2010 00:43
________________________________________
Marcela Saeb Lima - MSL Dermatopato (Mexico City) Wrote:

Beautiful mycosis fungoides

Submitted on 20/07/2010 00:34
________________________________________
Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Mycosis Fungoides

Submitted on 20/07/2010 00:25
________________________________________
Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Atypical lymphocytes surrounded with clear haloes are seen in collections within the epidermis (Pautrier microabscesses). Haphazardly arranged wiry collagen bundles in papillary dermis with dermal lymphocytic infiltrate. Diagnosis: Mycosis Fungoides (Primary cutaneous epidermotropic TCL).

Submitted on 20/07/2010 00:09
________________________________________

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share_externally

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