Ultrasound as a robust tool for lymph node staging in cutaneous T-cell lymphoma: guiding the necessity for invasive biopsy

Summary: Abstract Body: Accurate assessment of lymph node (LN) involvement is crucial for determining disease progression and treatment strategies in cutaneous T-cell lymphoma (CTCL). However, the reliance on biopsy for evaluating LN involvement poses risks that limit its widespread application. This underscores the need for non-invasive methods to identify patients who may benefit from biopsy. In the current study, we found that ultrasound detects lymphadenopathy in CTCL patients with high sensitivity and is strongly correlated with disease staging and prognosis in mycosis fungoides (MF), the most common type of CTCL. Key ultrasound parameters, including increased short-axis diameter (p = 0.0038) and loss of the echogenic hilum (p = 0.0376), were significant indicators of malignant LN involvement. ROC curve analysis revealed that combining short-axis diameter with the echogenic hilum provides superior predictive value for malignant lymphadenopathy. The identified cut-off values offer valuable prognostic insights for MF patients and may help clinicians identify those requiring LN biopsy or more aggressive procedures. This study highlights that ultrasound is an effective, non-invasive tool for detecting and monitoring malignant LN involvement in CTCL, guiding clinicians in determining the necessity of invasive biopsy. Yujie Wen¹, Chang Liu², Wei Wang³, Zhuojing Chen¹, Huizhong Wang¹, Jingru Sun¹, Luzeng Chen², Yang Wang¹ 1. Department of Dermatology and Venereology, Peking University First Hospital, Beijing, Beijing, China. 2. Department of Ultrasound, Peking University First Hospital, Beijing, Beijing, China. 3. Department of Pathology, Peking University First Hospital, Beijing, Beijing, China. Clinical Research: Epidemiology and Observational Research