Parameters:
(1) clinical findings: basic and additional
(2) histopathologic findings: basic and additional
(3) molecular biological findings
(4) immunopathologic findings
Basic clinical feature: persistent and/or progressive patches/thin plaques
Additional clinical findings:
(1) involvement of non-sun exposed skin
(2) size/shape variation
(3) poikiloderma
Basic histopathological findings: superficial lymphoid infiltrate
Additional histopathologic findings:
(1) epidermotropism without spongiosis
(2) lymphoid atypia (enlarged hyperchromatic nuclei; irregular or cerebriform nuclear contours)
Molecular biological findings:
(1) clonal TCR gene rearrangement
Immunopathologic findings:
(1) < 50% CD2+, CD3+ and/or CD5+ T cells
(2) < 10% CD7+ T cells
(3) epidermal/dermal discordance of CD2, CD3, CD5 or CD7 (T-cell antigen deficiency confined to the epidermis)
|
Parameter
|
Basic
|
Additional
|
Points
|
|
clinical
|
present
|
2 or 3
|
2
|
|
|
present
|
1
|
1
|
|
|
present
|
0
|
0
|
|
|
absent
|
NA
|
0
|
|
histopathological
|
present
|
2
|
2
|
|
|
present
|
1
|
1
|
|
|
present
|
0
|
0
|
|
|
absent
|
0
|
0
|
|
molecular
|
clonal
|
NA
|
1
|
|
|
non-clonal
|
NA
|
0
|
|
immunopathologic findings
|
1, 2 or 3
|
NA
|
1
|
|
|
0
|
NA
|
0
|
total score =
= SUM(points for the 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score >= 4 is diagnostic for early mycosis fungoides.
