Biopsy Requisition Builder
Communicate the clinical differential and review proposed testing with pathology.
Why this matters
Provide the clinical differential and relevant history for clinicopathologic correlation. A nonspecific report is not automatically an error or a negative test for MF.International expert panel (2022): suspected early MF
Specimen details
Biopsy pearls
International expert panel (2022): suspected early MF
- Expert-panel guidance for suspected early MF: obtain at least two representative punch samples, preferably 6 mm; consider deeper sampling for suspected follicular involvement.
- The panel advises stopping topical corticosteroids and other skin-directed therapies for at least two weeks before sampling. Individualize interruption with the treating clinician.
- App workflow reminder: confirm specimen handling and ancillary testing with the receiving laboratory before sampling.
Requisition text
Paste into the pathology order's clinical history field.
CLINICAL HISTORY / REQUEST TO PATHOLOGY Clinical question: Rule out mycosis fungoides / cutaneous T-cell lymphoma (CTCL). Specimen: lesion. Suggested immunohistochemistry for pathology review (app template; tailor to differential): CD3, CD4, CD8, CD7, CD30, CD20 Please correlate with clinical presentation and comment on features of MF/CTCL (epidermotropism, Pautrier microabscesses, atypical lymphocytes, CD7 loss).
Suggested immunohistochemistry
App template, not a mandatory diagnostic panel. Pathology selects stains for the differential.
International expert panel (2022): suspected early MFCD3Pan–T-cell marker; establishes T-cell lineage of the infiltrate.
CD4Helper T-cell marker; MF is typically CD4-predominant.
CD8Cytotoxic T-cell marker; assesses the CD4:CD8 ratio and CD8+ variants.
CD7Frequently reduced or lost in MF; a supporting feature but not specific (CD7 loss also occurs in benign dermatoses).
CD30Assesses CD30 expression; expression alone does not diagnose transformation or a lymphoma subtype.
CD20B-cell marker; interpret within the full morphologic and immunophenotypic assessment.
Molecular studies
International expert panel (2022): suspected early MF
TCR gene rearrangement (PCR or NGS)
An ancillary study: a clone alone does not establish MF, and a negative result does not exclude it. Interpret with clinical and histologic findings.