Staging laparotomy in cutaneous T-cell disease

Abstract

Staging laparotomy performed in 13 patients with various forms of cutaneous T cell disease (mycosis fungoides, Sezary syndrome, cutaneous lymphoma, atrophic parapsoriasis and alopecia mucinosa) showed evidence of visceral or lymph node involvement in 3 (23%) patients; in 2 of these patients, noninvasive investigations and staging procedures did not disclose any abnormalities. All 3 patients were alive after a mean follow-up period of 3.5 yr. In the 10 patients with normal findings at laparotomy, the presence of intra-abdominal lymphoma was suggested in 6 by noninvasive staging procedures (lymphangiogram, spleen or liver-spleen scan and computerized tomographic scan of the abdomen). Five of these 10 patients died; 4 of the 5 patients died after progression of the disease and visceral involvement. Staging laparotomy may have a role in the management of cutaneous T cell disease because noninvasive investigations may be poor indicators of the presence or absence of intra-abdominal disease. The course of these patients, even those in whom laparotomies did not show any abnormalities, emphasizes the progressive potential of cutaneous T cell disease.