Help me code for dx year :
Mycosis fungoides is a mature T-cell lymphoma presenting in the skin with patches/plaques and characterized by epidermal and dermal infiltration of small to medium-sized T-cells with cerebriform nuclei. So-called "Pautrier microabscesses," consisting of aggregates of cerebriform (highly folded) cells in the epidermis are highly characteristic.
Although patients with mycosis fungoides (MF) typically experience an indolent disease course, a minority undergo a process of large-cell transformation (LCT), which often heralds more aggressive disease and shortened survival. Regrettably, most dermatologists are unfamiliar with LCT, and even fewer understand how to recognize it clinically. Because a diagnosis of LCT typically triggers more aggressive therapy and/or referral to cutaneous T-cell lymphoma (CTCL) centers, it is paramount for clinicians to be able to recognize suspect lesions visually.
There are three variants to mycosis fungoides: folliculotropic MF, pagetoid reticulosis, and granulomatous slack skin. All are coded to 9700/3.
Folliculotropic MF is characterized by the presence of follicular infiltrates of atypical (cerebriform) CD4+ T lymphocytes often with sparing of the epidermis. Most cases show mucinous degeneration of the hair folicles (follicular mucinosis) but similar cases without follicular mucinosis have been reported. The lesions preferentially involve the head and neck area and often present with grouped follicular papules associated with alopecia. The disease is less accessible to skin-targeted therapies. The disease-specific 5-year survival is approximately 70-80%, which is significantly worse than that of patients with classical plaque stage MF.
Pagetoid reticulosis is characterized by the presence of patches or plaques with an intraepidermal proliferator of neoplastic T-cells.
Granulomatous slack skin (GSS) is an extremely rare subtype of Cutaneous T=cell lymphoma characterized by the slow development of folds of skin in the major skin folds (axilla, groin) and histologically by a granulomatous infiltrate. Most patients have an indolent clinical course.