{"id":7599,"date":"2020-04-25T03:33:01","date_gmt":"2020-04-25T06:33:01","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/patologia-de-micosis-fungoide\/"},"modified":"2020-04-30T21:09:03","modified_gmt":"2020-05-01T00:09:03","slug":"patologia-de-micosis-fungoide","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-de-micosis-fungoide\/","title":{"rendered":"Pathology of mycosis fungoides"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_87_1 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-de-micosis-fungoide\/#Introduccion\" >Introduction<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-de-micosis-fungoide\/#Histologia-de-micosis-fungoide\" >Histolog\u00eda de micosis fungoide<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-de-micosis-fungoide\/#Patologia-de-micosis-fungoide\" >Pathology of mycosis fungoides<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-de-micosis-fungoide\/#Estudios-especiales-para-micosis-fungoide\" >Estudios especiales para micosis fungoide<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-de-micosis-fungoide\/#los-diagnostico-diferencial-para-micosis-fungoide\" >los diagn\u00f3stico diferencial para micosis fungoide<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"Introduccion\"><\/span>Introduction<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>La micosis fungoide es la forma m\u00e1s com\u00fan de <span class=\"term\" data-term-id=\"47\">cutaneous<\/span> <span class=\"term\" data-term-id=\"416\">T cell<\/span> <span class=\"term\" data-term-id=\"976\">lymphoma<\/span>. It is characterized by <span class=\"term\" data-term-id=\"542\">infiltrators<\/span> of <span class=\"term\" data-term-id=\"421\">lymphocytes<\/span>. Tiene un <span class=\"term\" data-term-id=\"1532\">indolent<\/span> curso cl\u00ednico, generalmente progresando lentamente de parches a m\u00e1s gruesos <span class=\"term\" data-term-id=\"368\">plates<\/span> y eventualmente a tumores.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Histologia-de-micosis-fungoide\"><\/span>\n<span class=\"term\" data-term-id=\"128\">Histology<\/span> de micosis fungoide<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>En micosis fungoide, el <span class=\"term\" data-term-id=\"129\">histopathology<\/span> se caracteriza por infiltrados de <span class=\"term\" data-term-id=\"176\">evil one<\/span> <span class=\"term\" data-term-id=\"417\">T cells<\/span>. Estos son peque\u00f1os, medianos y caracter\u00edsticamente tienen cerebriformes irregulares. <span class=\"term\" data-term-id=\"729\">nuclei<\/span>. Las etapas cl\u00ednicas (<span class=\"term\" data-term-id=\"224\">patch<\/span>, <span class=\"term\" data-term-id=\"235\">license plate<\/span>, <span class=\"term\" data-term-id=\"289\">tumor<\/span>) correlacionar con el <span class=\"term\" data-term-id=\"1759\">progressive<\/span> densidad de c\u00e9lulas T malignas.<\/p>\n<p>Parche etapa micosis fungoides: hay una superficial <span class=\"term\" data-term-id=\"168\">lichenoid<\/span> <span class=\"term\" data-term-id=\"541\">infiltrate<\/span>, principalmente linfocitos y <span class=\"term\" data-term-id=\"858\">histiocytes<\/span> y unos pocos <span class=\"term\" data-term-id=\"1395\">atypical<\/span> cells infiltrating the <span class=\"term\" data-term-id=\"85\">epidermis<\/span> without significant <span class=\"term\" data-term-id=\"269\">spongiosis<\/span> (un fen\u00f3meno que se conoce como &#8216;<span class=\"term\" data-term-id=\"96\">exocytosis<\/span>&#8216;, Figura 1). Esta etapa puede ser muy sutil. <span class=\"term\" data-term-id=\"1420\">histopathologically<\/span> e imitar a otros <span class=\"term\" data-term-id=\"329\">skin disease<\/span> how <span class=\"term\" data-term-id=\"491\">eczema<\/span> o dermatosis liquenoides, como la <span class=\"term\" data-term-id=\"1305\">atypia<\/span> Puede ser dif\u00edcil de apreciar. A menudo m\u00faltiples <span class=\"term\" data-term-id=\"1111\">biopsies<\/span> son necesarios para hacer el diagn\u00f3stico y pueden ser necesarios numerosos estudios para aislar o probar un <span class=\"term\" data-term-id=\"1678\">clone<\/span> <span class=\"term\" data-term-id=\"893\">proliferation<\/span> de c\u00e9lulas T.<\/p>\n<p>Etapa de la placa: a medida que progresa la micosis fungoide, hay m\u00e1s obvio <span class=\"term\" data-term-id=\"86\">epidermotropism<\/span> (figura 2) y una m\u00e1s densa <span class=\"term\" data-term-id=\"52\">dermal<\/span> infiltrado. Puede haber <span class=\"term\" data-term-id=\"1038\">intraepidermal<\/span> colecciones de c\u00e9lulas at\u00edpicas (Pautrier <span class=\"term\" data-term-id=\"1454\">microabscesses<\/span>, figura 3).<\/p>\n<p>Etapa del tumor: cuando los tumores comienzan a formarse cl\u00ednicamente, la histopatolog\u00eda muestra un infiltrado d\u00e9rmico mucho m\u00e1s denso (figura 4). Puede que no haya exocitosis de linfocitos en esta etapa. La transformaci\u00f3n a c\u00e9lulas grandes puede ocurrir (figura 5).<\/p>\n<p>Hay numerosos cl\u00ednicos y <span class=\"term\" data-term-id=\"1419\">histopathological<\/span> variantes de micosis fungoide incluyendo una variante foliculotr\u00f3pica (figura 6), un <span class=\"term\" data-term-id=\"1076\">granulomatous<\/span> variante (piel floja granulomatosa <span class=\"term\" data-term-id=\"350\">syndrome<\/span>) y variantes que imitan dermatosis comunes como <span class=\"term\" data-term-id=\"1520\">pigmented<\/span> purpuric <span class=\"term\" data-term-id=\"53\">dermatitis<\/span> y vitiligo.<\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Patologia-de-micosis-fungoide\"><\/span>Pathology of mycosis fungoides<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='mycosis-fungoides-figure-1__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildqwxq-2752533-5247612' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/mycosis-fungoides-figure-1__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDQwXQ-2752533.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 1<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='mycosis-fungoides-figure-2__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildi5xq-2966205-9820287' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/mycosis-fungoides-figure-2__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDI5XQ-2966205.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 2<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='mycosis-fungoides-figure-3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildixxq-9426480-3127355' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/mycosis-fungoides-figure-3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDIxXQ-9426480.jpg'>\n<\/div>\n<p class=\"p-small\">figure 3<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='mycosis-fungoides-figure-4__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkilde5xq-4154050-4524368' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/mycosis-fungoides-figure-4__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDE5XQ-4154050.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 4<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='mycosis-fungoides-figure-5__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildq3xq-8741391-7648001' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/mycosis-fungoides-figure-5__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDQ3XQ-8741391.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 5<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='mycosis-fungoides-figure-6__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildq3xq-5325879-6400265' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/mycosis-fungoides-figure-6__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDQ3XQ-5325879.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 6<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Estudios-especiales-para-micosis-fungoide\"><\/span>Estudios especiales para micosis fungoide<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>En casos dif\u00edciles, puede ser \u00fatil probar la presencia de proliferaci\u00f3n clonal de c\u00e9lulas T para hacer el diagn\u00f3stico. Esto se puede hacer con <span class=\"term\" data-term-id=\"1421\">immunohistochemistry<\/span> y c\u00e9lulas T <span class=\"term\" data-term-id=\"774\">gene<\/span> estudios de reordenamiento.<\/p>\n<p>Inmunohistoqu\u00edmica: la micosis fungoide generalmente muestra un predominio de c\u00e9lulas T CD4 + con menos c\u00e9lulas CD8 + (aunque existen variantes de CD8). La proporci\u00f3n de CD4 \/ CD8 se puede evaluar y si hay restricci\u00f3n de un tipo, esto indicar\u00eda evidencia de clonalidad. CD4 tambi\u00e9n puede ser \u00fatil para resaltar el grado de c\u00e9lulas T <span class=\"term\" data-term-id=\"543\">infiltration<\/span> en la epidermis Las c\u00e9lulas T clonales tambi\u00e9n a menudo pierden <span class=\"term\" data-term-id=\"631\">T cell<\/span> marcador; c\u00e9lulas T malignas a veces negativas para CD7 y CD5.<\/p>\n<p>Los estudios de reordenamiento de genes de c\u00e9lulas T demuestran una poblaci\u00f3n clonal de c\u00e9lulas T en la mayor\u00eda de los casos<\/p>\n<h2><span class=\"ez-toc-section\" id=\"los-diagnostico-diferencial-para-micosis-fungoide\"><\/span>the <span class=\"term\" data-term-id=\"813\">differential diagnosis<\/span> para micosis fungoide<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Other diagnoses to consider include:<\/p>\n<ul>\n<li>Las dermatosis, la psoriasis, el eccema y las dermatosis liquenoides pueden imitar la micosis fungoide. En ocasiones, se necesitan biopsias m\u00faltiples, una cuidadosa correlaci\u00f3n cl\u00ednica y estudios especiales para asegurar el diagn\u00f3stico de micosis fungoide.<\/li>\n<li>Otros linfomas cut\u00e1neos, muchos otros <span class=\"term\" data-term-id=\"1402\">lymphoproliferative<\/span> los trastornos pueden imitar la micosis fungoide <span class=\"term\" data-term-id=\"1669\">histologically<\/span>. S\u00edndrome de S\u00e9zary, CD8 + <span class=\"term\" data-term-id=\"435\">cytotoxic<\/span> el linfoma de c\u00e9lulas T agresivo y la forma de micosis fungoide de papulosis linfomatosa (tipo B) son simuladores particularmente cercanos y necesitan correlaci\u00f3n con la presentaci\u00f3n cl\u00ednica para excluir<\/li>\n<li>Vitiligo &#8211; temprano <span class=\"term\" data-term-id=\"490\">inflammatory<\/span> Las fases del vitiligo pueden imitar la micosis fungoide. Esto es particularmente problem\u00e1tico en casos de <span class=\"term\" data-term-id=\"816\">hypopigmented<\/span> micosis fungoide. La correlaci\u00f3n con estudios especiales puede ser particularmente \u00fatil en estos casos.<\/li>\n<\/ul>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Introducci\u00f3n La micosis fungoide es la forma m\u00e1s com\u00fan de cut\u00e1neo c\u00e9lula T linfoma. Se caracteriza por infiltrados de linfocitos. Tiene un indolente curso cl\u00ednico, generalmente progresando lentamente de parches&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[205],"class_list":["post-7599","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones","tag-patologia"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7599","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=7599"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7599\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=7599"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=7599"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=7599"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}