Cutaneous B ‐cell lymphomas: 2016 update on diagnosis, risk‐stratification, and management

Disease overviewApproximately one‐fourth of cutaneous lymphomas are B‐cell derived and are generally classified into three distinct subgroups: primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous marginal zone lymphoma (PCMZL), and primary cutaneous diffuse large B‐cell lymphoma, leg type (PCDLBCL, LT).
DiagnosisDiagnosis and disease classification is based on histologic review and immunohistochemical staining of an appropriate skin biopsy. Pathologic review and an appropriate staging evaluation are necessary to distinguish primary cutaneous B‐cell lymphomas from systemic B‐cell lymphomas with secondary skin involvement.
Risk‐stratificationDisease histology remains the most important prognostic determinant. Both PCFCL and PCMZL are indolent lymphomas that infrequently disseminate to extracutaneous sites and are associated with 5‐year survival rates that exceed 95%. In contrast, PCDLBCL, LT is an aggressive lymphoma with an inferior prognosis.
Risk‐adapted therapyPCFCL and PCMZL patients with solitary or relatively few skin lesions may be affectively managed with local radiation therapy. While single‐agent rituximab may be employed for patients with more widespread skin involvement, multiagent chemotherapy is rarely appropriate. In contrast, management of patients with PCDLBCL, LT is comparable to the management of patients with systemic DLBCL. Am. J. Hematol. 91:1052–1055, 2016. © 2016 Wiley Periodicals, Inc.

Source: American Journal of Hematology - September 20, 2016 Category: Hematology Authors: Ryan A. Wilcox Tags: CME Information: Cutaneous B ‐cell lymphomas: 2016 update on diagnosis, risk‐stratification, and management Source Type: research