Algorithm of Song et al for Early Mycosis Fungoides (MF, Modified Score of Pimpinelli et al)

 

Parameters:

(1) clinical features

(2) histpathologic features

(3) molecular feature (clonal T-cell receptor gene rearrangement)

(4) immunophenotypic features

 

Clinical features:

(1) progressive and/or persistent patches and/or thin plaques

(2) location in non-sun-exposed skin

(3) variation in size and shape present

(4) poikiloderma

 

Histopathologic features:

(1) superficial lymphoid infiltrate

(2) epidermotropism without spongiosis

(3) lymphoid atypia

 

Immunophenotypic features:

(1) CD7 positive cells < 10%

(2) T-cell antigen loss confined to the epidermis

(3) (percent T cells CD2 positive < 50%) OR (percent T cells CD3 positive < 50%) OR (percent T cells CD5 positive < 50%) = loss of one or more pan-T-cell markers

 

Paramter	Finding	Points
clinical	(feature 1) + (2 or 3 of items 2 to 4)	2
	(feature 1) + (1 of items 2 to 4)	1
	any other combination	0
histopathology	(feature 1) + (both 2 and 3)	2
	(feature 1) + (either 2 or 3)	1
	any other combination	0
clonal T cell receptor	present	1
	absent	0
immunophenotype	>= 1 immunophenotypic features	1
	0 immunophenotypic features	0

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score 6

• A score >= 4 is diagnostic for early Mycosis Fungoides.