When is biopsy indicated in the workup of cutaneous T-cell lymphoma (CTCL)?

Updated: Aug 15, 2018
  • Author: Lauren C Pinter-Brown, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Perform a skin punch biopsy, which is submitted on sodium chloride–soaked gauze to allow for fixation and snap freezing.

Perform a bone marrow examination only if the patient has proven blood or nodal involvement.

Perform a lymph node biopsy if the nodes are palpable. In a study by Pai et al, the investigators determined that fine-needle aspiration (FNA) biopsy combined with immunophenotyping and T-cell receptor gamma chain PCR (TCR-gamma PCR) assay was “significantly useful” in evaluating lymphadenopathy in patients with mycosis fungoides or, specifically, Sézary syndrome, “especially for triaging lymph nodes that would otherwise not be sampled or for evaluating multiple lymph nodes." [80]


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