Sonographic Assessment of Peripheral Lymph Nodes In Early-Stage Mycosis Fungoides: Diagnostic Value And Prognostic Implications.

INTRODUCTION

Imaging studies are infrequently performed in patients with early-stage mycosis fungoides (MF), resulting in limited research on lymph nodes within this group.

OBJECTIVES

To determine which patient groups are more likely to have sonographically pathological lymph nodes and to assess the relationship between sonographic lymph node features and progression to advanced stage.

METHODS

Characteristics of early-stage MF patients with lymphadenopathy were recorded retrospectively. Logistic regression analyses were performed to evaluate associations between patient characteristics and sonographic findings as well as to assess the relationship between sonographic features and progression to advanced disease stages.

RESULTS

In the study, 70 patients were examined, revealing lymphadenopathy at a single site in 18.6% and multiple sites in 81.4%. The average long axis length was 23.4 mm, and the average short axis length was 8.4 mm. Diffuse cortical thickening was observed in 14.4%, asymmetric thickening in 3.8%, fatty hilum loss in 4.8%, heterogeneity in 1%, contour irregularity in 0.5%, and non-hilar, disorganized blood flow in 0.5% of the lymph nodes. Biopsies were performed on 13 lymph nodes post-ultrasound, with 195 nodes monitored subsequently. Of these, 42 nodes did not regress, while 153 regressed. A total of 30 lymph nodes were biopsied, identifying 28 as N1, one as N2, and one as N3. Younger age and elevated beta-2 microglobulin levels correlated with pathological features and persistent lymphadenopathy.

CONCLUSIONS

Considering the potential morbidities linked to lymph node biopsy, evaluating ultrasound features might be essential to patient selection. An earlier biopsy could be justified in younger patients with increased beta-2 microglobulin levels.