Materiały źródłowe

• #1 Primary Cutaneous B-Cell Lymphoma: An Update on Pathologic and Molecular Features

  https://www.mdpi.com/2673-6357/3/2/23

  Primary cutaneous B-cell lymphomas (PCBCLs) account for 25% of all primary cutaneous lymphomas. Three major types are currently recognized by the WHO classification: primary cutaneous marginal zone B-cell lymphoma (PCMZL), primary cutaneous follicle centre lymphoma (PCFCL) (both considered indolent lymphomas) and primary cutaneous diffuse large B-cell lymphoma, leg-type (PCDLBCL-LT), which is, instead, a very aggressive disease. […] PCBCL diagnosis and management is a multidisciplinary task, involving dermatologists, pathologists, haemato-oncologists and radiation oncologists. The diagnosis of PCBCL needs careful histomorphological and immunophenotypical analyses, corroborated by clinical data and, when necessary, by molecular and cytogenetic investigations. […] Current WHO (2017) classification recognizes three types of PCBCLs as being most frequent: (1) primary cutaneous marginal zone B-cell lymphoma (PCMZL); (2) primary cutaneous follicle centre lymphoma (PCFCL); and (3) primary cutaneous diffuse large B-cell lymphoma, leg-type (PCDLBCL-LT).

• #2 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. […] Given the clinical suspicion, the diagnosis is established by skin biopsy, through histological and cytological examinations, eventually complemented by immunohistochemical and immunophenotypic, cytogenetic and genotypic studies. […] The pattern of cutaneous involvement by PCBCL differs from that observed in PCTCL, being characterized by a nodular or diffuse, often sharply demarcated, non-epidermotropic lymphoid infiltrate, located predominantly in the dermis, and sparing the sub-epidermal „Grenz zone”. […] Immunohistochemistry for lymphoma characterization should include different types of markers: a) markers to demonstrate B-cell origin (e.g. CD19, CD20 and CD79a); b) markers to characterize expanded B-cell population (e.g., CD5 and CD10) and to evaluate clonality (immunoglobulin kappa and lambda light chains); as well as c) markers to characterize accompanying cells consisting of plasma cells (e.g. CD138), T-cells (e.g. CD3, CD4, CD8), and follicle dendritic cells (e.g. CD21).

• #3 Cutaneous B-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37434388/

  Diagnosis: Diagnosis and disease classification is based on histopathologic 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-adapted therapy: PCFCL and PCMZL patients with solitary or relatively few skin lesions may be effectively 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.

• #4 Cutaneous B-Cell Lymphoma – Lymphoma Research Foundation

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/cbcl/

  There are four types of CBCL: […] Primary Cutaneous Marginal Zone B-Cell Lymphoma: This slow-growing lymphoma is the second most common form of CBCL and appears as pink or red lesions, nodules, and/ or tumors, most commonly found on the torso or arms. […] Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg-Type: This lymphoma usually appears as solitary or multiple tumor nodules on the legs, arms, and/or torso and is less common but usually more aggressive (fast-growing), developing over weeks or months. […] Primary Cutaneous Diffuse Large B-Cell Lymphoma, Other: This describes a group of very rare lymphomas, including intravascular large B-cell lymphoma, T-cellrich large B-cell lymphoma, plasmablastic lymphoma, and anaplastic B-cell lymphoma that usually appear on the head, torso, and extremities.

• #5 Primary Cutaneous B-Cell Lymphoma: An Update on Pathologic and Molecular Features

  https://www.mdpi.com/2673-6357/3/2/23

  Primary cutaneous B-cell lymphomas (PCBCLs) account for 25% of all primary cutaneous lymphomas. Three major types are currently recognized by the WHO classification: primary cutaneous marginal zone B-cell lymphoma (PCMZL), primary cutaneous follicle centre lymphoma (PCFCL) (both considered indolent lymphomas) and primary cutaneous diffuse large B-cell lymphoma, leg-type (PCDLBCL-LT), which is, instead, a very aggressive disease. […] PCBCL diagnosis and management is a multidisciplinary task, involving dermatologists, pathologists, haemato-oncologists and radiation oncologists. The diagnosis of PCBCL needs careful histomorphological and immunophenotypical analyses, corroborated by clinical data and, when necessary, by molecular and cytogenetic investigations. […] Current WHO (2017) classification recognizes three types of PCBCLs as being most frequent: (1) primary cutaneous marginal zone B-cell lymphoma (PCMZL); (2) primary cutaneous follicle centre lymphoma (PCFCL); and (3) primary cutaneous diffuse large B-cell lymphoma, leg-type (PCDLBCL-LT).

• #6

  https://link.springer.com/article/10.1007/s40257-022-00704-0

  Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. […] Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. […] To date, treatment recommendations for primary cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. […] An accurate pathologic diagnosis of the subtype is the most important first step in the management of pCBCLs. […] To appropriately confirm the diagnosis of pCBCL, systemic involvement must be ruled out. […] Management of pCBCL is complex and requires coordination of a multidisciplinary care team comprising dermatologists, pathologists, hematology-oncologists, and radiation oncologists. […] This review aims to describe the pathophysiological, epidemiological, clinicopathological, immunohistochemical, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management.

• #7 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #8 Cutaneous B-Cell Lymphoma: Types, Diagnosis, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22925-cutaneous-b-cell-lymphoma

  Cutaneous B-cell lymphoma (CBCL) is a rare type of cancer that starts in your skin. […] CBCL lesions can look like pimples, bug bites, allergic reactions, scabs or skin conditions (such as eczema or psoriasis). […] Your healthcare provider can diagnose CBCL with a physical examination and skin biopsy. […] A biopsy can identify skin lymphoma and its subtype. […] Your healthcare provider might order staging tests to determine whether the cancer has spread. […] CBCL stage describes whether the cancer has spread and how much. […] Most cases of CBCL can be treated and cured, but the condition may come back (recur). […] Treatment for CBCL depends on the subtype and stage. […] Prognosis depends on several factors, especially subtype and stage. […] Skin lymphoma often comes back after treatment. […] If you have CBCL or have had it in the past, its important to follow your healthcare providers instructions. […] If youve been diagnosed with cutaneous B-cell lymphoma, consider asking your healthcare provider: What CBCL subtype do I have?

• #9 Cutaneous B-Cell Lymphoma: Symptoms, Treatment, and Diagnosis | MyLymphomaTeam

  https://www.mylymphomateam.com/resources/cutaneous-b-cell-lymphoma

  Cutaneous B-cell lymphoma (CBCL) is a rare type of non-Hodgkin lymphoma that develops in the B lymphocytes (or B cells) and affects the skin hence the term cutaneous. […] Diagnosing cutaneous B-cell lymphoma can take months or years from the time the nodules or rash first appears. CBCL can mimic the appearance of many other skin conditions. A skin biopsy the removal and testing of a small sample of tissue is usually required to diagnose CBCL. […] Because of this, it may take several biopsies over the course of many years before a diagnosis of cutaneous B-cell lymphoma is confirmed. […] Other tests and procedures used to diagnose cutaneous B-cell lymphoma include: A physical exam Your doctor will examine your skin, check for swollen lymph nodes, and ask about other symptoms. Blood tests Blood tests for lymphoma involve analyzing a sample of your blood for the presence of lymphoma cells. Imaging tests Your doctor may use images from computerized tomography (CT) and positron emission tomography (PET) scans to help diagnose lymphoma. Bone marrow biopsy A sample of your bone marrow is collected with a needle and tested for the presence of lymphoma cells. […] Staging is determined during the diagnostic process for CBCL.

• #10 Early Detection of Cutaneous Lymphoma

  https://www.cancernetwork.com/view/early-detection-cutaneous-lymphoma

  Primary cutaneous follicle center cell lymphoma accounts for 40% of primary cutaneous B-cell lymphomas. […] Primary cutaneous follicle center cell lymphoma is characterized by plum-colored, firm, indurated nodules that have a smooth surface and lack scales. […] A thorough work-up of patients with cutaneous B-cell lymphoma will reveal extracutaneous involvement in about 25% of patients. […] Unlike cutaneous T-cell lymphoma, enlargement of peripheral lymph nodes in patients with cutaneous B-cell lymphoma usually indicates neoplastic infiltration as opposed to dermatopathic lymphadenopathy.

• #11 Cutaneous B-Cell Lymphoma – Lymphoma Research Foundation

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/cbcl/

  There are four types of CBCL: […] Primary Cutaneous Marginal Zone B-Cell Lymphoma: This slow-growing lymphoma is the second most common form of CBCL and appears as pink or red lesions, nodules, and/ or tumors, most commonly found on the torso or arms. […] Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg-Type: This lymphoma usually appears as solitary or multiple tumor nodules on the legs, arms, and/or torso and is less common but usually more aggressive (fast-growing), developing over weeks or months. […] Primary Cutaneous Diffuse Large B-Cell Lymphoma, Other: This describes a group of very rare lymphomas, including intravascular large B-cell lymphoma, T-cellrich large B-cell lymphoma, plasmablastic lymphoma, and anaplastic B-cell lymphoma that usually appear on the head, torso, and extremities.

• #12 Primary cutaneous diffuse large B cell lymphoma, leg type – UpToDate

  https://www.uptodate.com/contents/primary-cutaneous-diffuse-large-b-cell-lymphoma-leg-type

  Primary cutaneous B cell lymphoma (PCBCL) refers to cases of B cell lymphoma that present in the skin, with no evidence of extracutaneous disease after completing the initial staging evaluation. […] There are three main subtypes of PCBCL, which have different clinical presentations, pathologic features, prognosis, and management: […] PCDLBCL, leg type is the least common subtype of PCBCLs. It is usually aggressive, and it is associated with a poor prognosis. […] PCDLBCL, leg type presents most often on the legs, but B cell lymphomas with similar pathologic features and prognosis can arise at other cutaneous sites. […] The term PCDLBCL, leg type is preferred both for lesions on the legs and similar lesions at other skin sites.

• #13 OBTAINING A PROPER CUTANEOUS LYMPHOMA DIAGNOSIS | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/obtaining-proper-cutaneous-lymphoma-diagnosis

  One of the most difficult things about uncommon diseases for both patients and physicians is reaching a correct diagnosis. […] A definitive diagnosis will help inform treatment decisions and potentially yield better patient-related outcomes over time. […] In the case of cutaneous lymphoma, a definitive diagnosis sometimes takes years. […] Since reactive processes and other types of inflammation can trigger symptoms similar to those of cutaneous lymphomas, evaluation by a provider with experience in diagnosing skin lymphoma is important if skin lymphoma is suspected. […] A definitive diagnosis cannot be obtained without a biopsy, and multiple biopsies are often necessary to confirm the diagnosis of cutaneous lymphoma. […] It is very important to confirm any diagnosis of cutaneous lymphoma by a specialized type of pathologist – dermatopathologist or a hematopathologist – who has expertise in diagnosing cutaneous lymphomas.

• #14 Cutaneous B-Cell Lymphoma: Symptoms, Treatment, and Diagnosis | MyLymphomaTeam

  https://www.mylymphomateam.com/resources/cutaneous-b-cell-lymphoma

  Cutaneous B-cell lymphoma (CBCL) is a rare type of non-Hodgkin lymphoma that develops in the B lymphocytes (or B cells) and affects the skin hence the term cutaneous. […] Diagnosing cutaneous B-cell lymphoma can take months or years from the time the nodules or rash first appears. CBCL can mimic the appearance of many other skin conditions. A skin biopsy the removal and testing of a small sample of tissue is usually required to diagnose CBCL. […] Because of this, it may take several biopsies over the course of many years before a diagnosis of cutaneous B-cell lymphoma is confirmed. […] Other tests and procedures used to diagnose cutaneous B-cell lymphoma include: A physical exam Your doctor will examine your skin, check for swollen lymph nodes, and ask about other symptoms. Blood tests Blood tests for lymphoma involve analyzing a sample of your blood for the presence of lymphoma cells. Imaging tests Your doctor may use images from computerized tomography (CT) and positron emission tomography (PET) scans to help diagnose lymphoma. Bone marrow biopsy A sample of your bone marrow is collected with a needle and tested for the presence of lymphoma cells. […] Staging is determined during the diagnostic process for CBCL.

• #15 Cutaneous Lymphoma Cancer Types, Symptoms, and Diagnosis

  https://www.ahn.org/services/cancer/types/cutaneous-lymphoma

  Diagnosis usually involves a skin biopsy, followed by further tests to determine the specific type of lymphoma. The disease is typically very slow growing and evolving. Multiple studies have shown patients typically undergo at least three biopsies over several months, or even years, before a diagnosis is confirmed. This cancer can look very similar to benign rashes such as eczema. […] A skin biopsy is the most important diagnostic tool in determining a cutaneous lymphoma diagnosis. In a biopsy, a sample of skin is taken and examined under a microscope to identify cancerous cells. There are different types of biopsies, but all are done using anesthetic, so you stay as comfortable as possible while the doctor is getting what they need for an accurate diagnosis. […] Types of biopsies include:

• #16 Cutaneous Lymphoma Cancer Types, Symptoms, and Diagnosis

  https://www.ahn.org/services/cancer/types/cutaneous-lymphoma

  Diagnosis usually involves a skin biopsy, followed by further tests to determine the specific type of lymphoma. The disease is typically very slow growing and evolving. Multiple studies have shown patients typically undergo at least three biopsies over several months, or even years, before a diagnosis is confirmed. This cancer can look very similar to benign rashes such as eczema. […] A skin biopsy is the most important diagnostic tool in determining a cutaneous lymphoma diagnosis. In a biopsy, a sample of skin is taken and examined under a microscope to identify cancerous cells. There are different types of biopsies, but all are done using anesthetic, so you stay as comfortable as possible while the doctor is getting what they need for an accurate diagnosis. […] Types of biopsies include:

• #17 Primary Cutaneous B-cell Lymphoma | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/primary-cutaneous-b-cell-lymphoma

  Primary cutaneous B-cell lymphoma (CBCL) is a form of cancer that originates from B cells that present in the skin and nowhere else in the body, often referred to as an extranodal (outside the lymph node) non-Hodgkins lymphoma. […] To be diagnosed with a primary cutaneous B cell lymphoma, you must have no evidence of systemic (internal) disease, usually done by medical imaging of the body at the time of presentation. However, in cases with a classic clinical presentation and pathology findings on biopsy, imaging may not be needed. […] When a skin biopsy shows B-cell lymphoma it is very important to make sure that the lymphoma is truly coming from the skin, and not from a systemic lymphoma that has spread to the skin. It is also important that any diagnosis of CBCL is confirmed by a pathologist who has expertise in diagnosing cutaneous lymphomas.

• #18 Cutaneous Lymphoma Cancer Types, Symptoms, and Diagnosis

  https://www.ahn.org/services/cancer/types/cutaneous-lymphoma

  Punch biopsy: A small, round piece of skin is removed using a special tool. […] Excisional biopsy: A larger area of skin is removed, often including the entire lesion. […] Shave biopsy: A thin layer of skin is shaved off. […] Your doctor will ask about your symptoms, family history of cancer, and any relevant medical conditions. They will examine your skin, lymph nodes, and other areas to assess the extent of the disease. Tests are performed to get a whole picture of your whole health. Each cancer case is different, and your care and treatment plan are unique to your needs. Whatever tests or screenings are needed, know that your AHN care team is here to find answers.

• #19 Primary cutaneous B cell lymphoma: Clinical features, diagnosis and treatment

  https://www.wjgnet.com/2218-6190/full/v4/i1/50.htm

  Primary cutaneous B cell lymphoma (PCBCL) is defined as B cell lymphomas that present in the skin without any evidence of extra-cutaneous involvement at diagnosis. They are the second most common type of PCL, accounting for 25%-30%. Since the prognosis and treatment differ from systemic lymphomas involving the skin, differential diagnosis becomes crucial. […] PCBCL is a heterogeneous group of diseases consisting different B cell lymphomas with distinct treatment and prognosis. Their clinical presentation is relatively uniform, mostly manifested by nodules. […] An adequate biopsy of the lesion, preferably excisional biopsy or a punch biopsy of at least 4 mm for routine histology and immunohistology is crucial for the diagnosis of PCL. […] The diagnosis of the disease can be established by histopathologic examination of the skin biopsy and exclusion of a systemic disease. Excisional biopsy is preferred but if an excisional biopsy is not appropriate, it can be substituted by a punch biopsy of an adequate length.

• #20 Cutaneous Lymphoma Cancer Types, Symptoms, and Diagnosis

  https://www.ahn.org/services/cancer/types/cutaneous-lymphoma

  Punch biopsy: A small, round piece of skin is removed using a special tool. […] Excisional biopsy: A larger area of skin is removed, often including the entire lesion. […] Shave biopsy: A thin layer of skin is shaved off. […] Your doctor will ask about your symptoms, family history of cancer, and any relevant medical conditions. They will examine your skin, lymph nodes, and other areas to assess the extent of the disease. Tests are performed to get a whole picture of your whole health. Each cancer case is different, and your care and treatment plan are unique to your needs. Whatever tests or screenings are needed, know that your AHN care team is here to find answers.

• #21 Cutaneous Lymphoma Cancer Types, Symptoms, and Diagnosis

  https://www.ahn.org/services/cancer/types/cutaneous-lymphoma

  Punch biopsy: A small, round piece of skin is removed using a special tool. […] Excisional biopsy: A larger area of skin is removed, often including the entire lesion. […] Shave biopsy: A thin layer of skin is shaved off. […] Your doctor will ask about your symptoms, family history of cancer, and any relevant medical conditions. They will examine your skin, lymph nodes, and other areas to assess the extent of the disease. Tests are performed to get a whole picture of your whole health. Each cancer case is different, and your care and treatment plan are unique to your needs. Whatever tests or screenings are needed, know that your AHN care team is here to find answers.

• #22 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  How is primary cutaneous marginal zone lymphoma diagnosed? After obtaining a full history from the patient and performing a physical examination and skin examination, the diagnosis is made based on an adequate full-thickness biopsy of the affected skin. […] A 46 mm punch, incisional, or excisional biopsy should be obtained. The biopsy specimen should include the reticular dermis and fat. […] Histologically, cutaneous marginal zone lymphomas show nodular to diffuse dermal infiltration of marginal zone B-cells, lymphocytes, lymphoplasmacytoid cells, and plasma cells combined with centroblast- or immunoblast-like cells and reactive T cells. Marginal zone B cells are small to medium in size and have irregular nuclei, inconspicuous nucleoli, and abundant pale cytoplasm. […] Immunohistochemistry tests of cutaneous marginal zone lymphomas are positive for CD20, CD79a, and BCL-2, and negative for CD 10, and BCL-6 cells.

• #23 Diagnosis and Management of Cutaneous B-cell Lymphoma | Plastic Surgery Key

  https://plasticsurgerykey.com/diagnosis-and-management-of-cutaneous-b-cell-lymphoma/

  The diagnosis of primary cutaneous B-cell lymphoma (CBCL) requires that the search for a more widespread lymphoma has been negative. […] A primary cutaneous B-cell lymphoma (CBCL) by definition is one in which the lymphoma involves no other tissue but skin at the time of diagnosis. […] The diagnosis of CBCL requires a 4-mm to 6-mm punch biopsy or incisional or excisional biopsy that includes the reticular dermis and subcutaneous fat. […] The treatment approach may vary widely between observation, local therapy, or systemic therapy depending on the histology and extent and area of skin involvement. Histology of the lesion determines prognosis. […] The diagnosis of a CBCL first requires a biopsy of these mostly papular or tumoral erythematous to violaceous skin lesions. To this end, a 4-mm to 6-mm punch biopsy or excisional or incisional biopsy that includes the reticular dermis and fat should be obtained.

• #24 Cutaneous B-Cell Lymphoma: Overview, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1099540-overview

  Cutaneous lymphomas represent a unique group of lymphomas and are the second most frequent extranodal lymphomas. They can be defined as lymphoproliferative skin infiltrates of T-cell, B-cell, or natural killer cell lineage, which primarily occur in and remain confined to the skin in most patients, without detectable extracutaneous manifestations at diagnosis. […] B-cell lymphomas account for the majority of nodal lymphomas, whereas primary cutaneous B-cell lymphomas (CBCLs) represent 20-25% of all cutaneous lymphomas. Because CBCLs have an overall favorable prognosis, proper recognition is vital for appropriate therapy and to avoid overtreatment in most cases. The tumor type and the extent of cutaneous involvement are the 2 most relevant prognostic factors in primary CBCL. […] The diagnosis of CBCL is established by analysis of skin biopsy specimen, using histomorphology and cytomorphology, immunohistochemistry and phenotypic features, and genotyping and cytogenetic studies.

• #25 OBTAINING A PROPER CUTANEOUS LYMPHOMA DIAGNOSIS | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/obtaining-proper-cutaneous-lymphoma-diagnosis

  One of the most difficult things about uncommon diseases for both patients and physicians is reaching a correct diagnosis. […] A definitive diagnosis will help inform treatment decisions and potentially yield better patient-related outcomes over time. […] In the case of cutaneous lymphoma, a definitive diagnosis sometimes takes years. […] Since reactive processes and other types of inflammation can trigger symptoms similar to those of cutaneous lymphomas, evaluation by a provider with experience in diagnosing skin lymphoma is important if skin lymphoma is suspected. […] A definitive diagnosis cannot be obtained without a biopsy, and multiple biopsies are often necessary to confirm the diagnosis of cutaneous lymphoma. […] It is very important to confirm any diagnosis of cutaneous lymphoma by a specialized type of pathologist – dermatopathologist or a hematopathologist – who has expertise in diagnosing cutaneous lymphomas.

• #26 Primary Cutaneous B-cell Lymphoma | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/primary-cutaneous-b-cell-lymphoma

  Primary cutaneous B-cell lymphoma (CBCL) is a form of cancer that originates from B cells that present in the skin and nowhere else in the body, often referred to as an extranodal (outside the lymph node) non-Hodgkins lymphoma. […] To be diagnosed with a primary cutaneous B cell lymphoma, you must have no evidence of systemic (internal) disease, usually done by medical imaging of the body at the time of presentation. However, in cases with a classic clinical presentation and pathology findings on biopsy, imaging may not be needed. […] When a skin biopsy shows B-cell lymphoma it is very important to make sure that the lymphoma is truly coming from the skin, and not from a systemic lymphoma that has spread to the skin. It is also important that any diagnosis of CBCL is confirmed by a pathologist who has expertise in diagnosing cutaneous lymphomas.

• #27 Tests for Lymphoma of the Skin | American Cancer Society

  https://www.cancer.org/cancer/types/skin-lymphoma/detection-diagnosis-staging/how-diagnosed.html

  Because this type of lymphoma affects the skin, it is often noticed fairly quickly. But the actual diagnosis of skin lymphoma might be delayed because the symptoms often resemble other, more common skin problems. The diagnosis of skin lymphoma can only be confirmed with a skin biopsy. A biopsy is a procedure in which a doctor removes a sample of body tissue for viewing under a microscope or other lab tests. A biopsy is needed to diagnose lymphoma of the skin. Many of the more common forms of skin cancer (and other skin diseases) can be diagnosed just by looking at the biopsy samples. But diagnosing and classifying lymphomas of the skin often requires one or more special lab tests. Diagnosing some forms of skin lymphoma can be very challenging. Sometimes, especially if the diagnosis is unclear, the skin samples may need to be sent to a dermatopathologist, a dermatologist or a pathologist with additional training in diagnosing skin samples. Even with this expertise, in some cases several biopsies may be need to be done in different areas of abnormal skin and/or at different times before the diagnosis is confirmed. Skin lymphomas often spread to lymph nodes, so your doctor may recommend a lymph node biopsy to help confirm the diagnosis or to help determine how widespread the lymphoma is. Removing a lymph node almost always provides enough tissue to diagnose the exact type of lymphoma. Most doctors prefer this type of biopsy, if it can be done without too much discomfort to the patient. Lab tests are done on the biopsy samples (and in some cases, blood samples) to help diagnose lymphoma and determine what type it is. Pathologists can sometimes tell which kind of lymphoma a person has by just looking at the cells under a microscope, but usually these other types of tests are needed to confirm the diagnosis.

• #28 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. […] Given the clinical suspicion, the diagnosis is established by skin biopsy, through histological and cytological examinations, eventually complemented by immunohistochemical and immunophenotypic, cytogenetic and genotypic studies. […] The pattern of cutaneous involvement by PCBCL differs from that observed in PCTCL, being characterized by a nodular or diffuse, often sharply demarcated, non-epidermotropic lymphoid infiltrate, located predominantly in the dermis, and sparing the sub-epidermal „Grenz zone”. […] Immunohistochemistry for lymphoma characterization should include different types of markers: a) markers to demonstrate B-cell origin (e.g. CD19, CD20 and CD79a); b) markers to characterize expanded B-cell population (e.g., CD5 and CD10) and to evaluate clonality (immunoglobulin kappa and lambda light chains); as well as c) markers to characterize accompanying cells consisting of plasma cells (e.g. CD138), T-cells (e.g. CD3, CD4, CD8), and follicle dendritic cells (e.g. CD21).

• #29 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  How is primary cutaneous marginal zone lymphoma diagnosed? After obtaining a full history from the patient and performing a physical examination and skin examination, the diagnosis is made based on an adequate full-thickness biopsy of the affected skin. […] A 46 mm punch, incisional, or excisional biopsy should be obtained. The biopsy specimen should include the reticular dermis and fat. […] Histologically, cutaneous marginal zone lymphomas show nodular to diffuse dermal infiltration of marginal zone B-cells, lymphocytes, lymphoplasmacytoid cells, and plasma cells combined with centroblast- or immunoblast-like cells and reactive T cells. Marginal zone B cells are small to medium in size and have irregular nuclei, inconspicuous nucleoli, and abundant pale cytoplasm. […] Immunohistochemistry tests of cutaneous marginal zone lymphomas are positive for CD20, CD79a, and BCL-2, and negative for CD 10, and BCL-6 cells.

• #30 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  The work-up of PCBCL should include a complete history, physical and skin examination. Initial blood tests should include: Full blood count and differential, Metabolic profile and lactate dehydrogenase. An adequate skin biopsy is also important for evaluation and staging. Either 4-6 mm punch, incisional, or excisional biopsies should be obtained and should include the reticular dermis and subcutaneous fat. Superficial biopsy specimens may not differentiate PCBCL from reactive or inflammatory processes. Histologically, PCBCL shows a diffuse monotonous population of centroblasts and immunoblasts. Histochemistry tests are essential to classify the exact type of lymphoma. […] PCFCL needs to be differentiated from a secondary cutaneous lymphoma, which is where a nodal follicular lymphoma has spread to involve the skin. Cellular morphology may vary with the age and size of the lesion. Histologically, PCFCL shows: Dermal and subcutaneous proliferation of centrocytes (cleaved follicle centre cells) and centroblasts (large transformed cells) in a follicular and/or diffuse growth pattern. Immunostaining shows: Positive B-cell antigens, ie CD20 and CD79a, Negative bcl-2 protein, and, the t(14;18) translocation (which if present may suggest systemic follicular lymphoma), Negative immunoglobulin M expression.

• #31 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  The histology of PCMZL consists of: Nodular to diffuse dermal infiltrates of marginal zone B-cells, lymphocytes, lymphoplasmacytoid cells, plasma cells admixed with reactive T cells and centroblast or immuneblast-like cells. Immunostaining shows Positive CD20, CD79a and Bcl-2, Negative CD10 and Bcl-6. […] PCFCL and PCDLBCL-LT have diffuse large B-cell infiltrates. PCDLBCL-LT shows: Diffuse dermal proliferation of centroblasts and immunoblasts in monotonous or confluent sheets, Large round nuclei with open chromatin, prominent nucleoli and identifiable mitotic figures, Sparse T cells confined to perivascular areas. […] The rarity of PCBCL and lack of comparative prospective, randomised studies limits the choice of therapy as most treatments are based on data from small retrospective studies. The European Organisation for Research and Treatment of Cancer Cutaneous Lymphoma Group (EORTC-CLG) and the International Society for Cutaneous Lymphoma (ISCL) have uniform recommendations on treating the three main types of PCBCL.

• #32

  https://journals.lww.com/cancerjournal/fulltext/2023/19050/primary_cutaneous_large_b_cell_lymphoma.71.aspx

  Primary cutaneous large B cell lymphoma, leg type is a rare and aggressive variant of cutaneous B cell lymphoma. […] A detailed histopathological and immunohistochemical analysis is essential for its correct diagnosis and management. […] Histopathology combined with ancillary techniques such as immunohistochemistry and molecular studies is essential for its correct diagnosis. […] Immunohistochemistry is essential for a correct diagnosis. […] A detailed histopathological and immunohistochemical analysis helps in achieving the correct diagnosis and, initiation of appropriate management.

• #33 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. […] Given the clinical suspicion, the diagnosis is established by skin biopsy, through histological and cytological examinations, eventually complemented by immunohistochemical and immunophenotypic, cytogenetic and genotypic studies. […] The pattern of cutaneous involvement by PCBCL differs from that observed in PCTCL, being characterized by a nodular or diffuse, often sharply demarcated, non-epidermotropic lymphoid infiltrate, located predominantly in the dermis, and sparing the sub-epidermal „Grenz zone”. […] Immunohistochemistry for lymphoma characterization should include different types of markers: a) markers to demonstrate B-cell origin (e.g. CD19, CD20 and CD79a); b) markers to characterize expanded B-cell population (e.g., CD5 and CD10) and to evaluate clonality (immunoglobulin kappa and lambda light chains); as well as c) markers to characterize accompanying cells consisting of plasma cells (e.g. CD138), T-cells (e.g. CD3, CD4, CD8), and follicle dendritic cells (e.g. CD21).

• #34 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. […] Given the clinical suspicion, the diagnosis is established by skin biopsy, through histological and cytological examinations, eventually complemented by immunohistochemical and immunophenotypic, cytogenetic and genotypic studies. […] The pattern of cutaneous involvement by PCBCL differs from that observed in PCTCL, being characterized by a nodular or diffuse, often sharply demarcated, non-epidermotropic lymphoid infiltrate, located predominantly in the dermis, and sparing the sub-epidermal „Grenz zone”. […] Immunohistochemistry for lymphoma characterization should include different types of markers: a) markers to demonstrate B-cell origin (e.g. CD19, CD20 and CD79a); b) markers to characterize expanded B-cell population (e.g., CD5 and CD10) and to evaluate clonality (immunoglobulin kappa and lambda light chains); as well as c) markers to characterize accompanying cells consisting of plasma cells (e.g. CD138), T-cells (e.g. CD3, CD4, CD8), and follicle dendritic cells (e.g. CD21).

• #35 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. […] Given the clinical suspicion, the diagnosis is established by skin biopsy, through histological and cytological examinations, eventually complemented by immunohistochemical and immunophenotypic, cytogenetic and genotypic studies. […] The pattern of cutaneous involvement by PCBCL differs from that observed in PCTCL, being characterized by a nodular or diffuse, often sharply demarcated, non-epidermotropic lymphoid infiltrate, located predominantly in the dermis, and sparing the sub-epidermal „Grenz zone”. […] Immunohistochemistry for lymphoma characterization should include different types of markers: a) markers to demonstrate B-cell origin (e.g. CD19, CD20 and CD79a); b) markers to characterize expanded B-cell population (e.g., CD5 and CD10) and to evaluate clonality (immunoglobulin kappa and lambda light chains); as well as c) markers to characterize accompanying cells consisting of plasma cells (e.g. CD138), T-cells (e.g. CD3, CD4, CD8), and follicle dendritic cells (e.g. CD21).

• #36 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. […] Given the clinical suspicion, the diagnosis is established by skin biopsy, through histological and cytological examinations, eventually complemented by immunohistochemical and immunophenotypic, cytogenetic and genotypic studies. […] The pattern of cutaneous involvement by PCBCL differs from that observed in PCTCL, being characterized by a nodular or diffuse, often sharply demarcated, non-epidermotropic lymphoid infiltrate, located predominantly in the dermis, and sparing the sub-epidermal „Grenz zone”. […] Immunohistochemistry for lymphoma characterization should include different types of markers: a) markers to demonstrate B-cell origin (e.g. CD19, CD20 and CD79a); b) markers to characterize expanded B-cell population (e.g., CD5 and CD10) and to evaluate clonality (immunoglobulin kappa and lambda light chains); as well as c) markers to characterize accompanying cells consisting of plasma cells (e.g. CD138), T-cells (e.g. CD3, CD4, CD8), and follicle dendritic cells (e.g. CD21).

• #37 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  How is primary cutaneous marginal zone lymphoma diagnosed? After obtaining a full history from the patient and performing a physical examination and skin examination, the diagnosis is made based on an adequate full-thickness biopsy of the affected skin. […] A 46 mm punch, incisional, or excisional biopsy should be obtained. The biopsy specimen should include the reticular dermis and fat. […] Histologically, cutaneous marginal zone lymphomas show nodular to diffuse dermal infiltration of marginal zone B-cells, lymphocytes, lymphoplasmacytoid cells, and plasma cells combined with centroblast- or immunoblast-like cells and reactive T cells. Marginal zone B cells are small to medium in size and have irregular nuclei, inconspicuous nucleoli, and abundant pale cytoplasm. […] Immunohistochemistry tests of cutaneous marginal zone lymphomas are positive for CD20, CD79a, and BCL-2, and negative for CD 10, and BCL-6 cells.

• #38 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  The work-up of PCBCL should include a complete history, physical and skin examination. Initial blood tests should include: Full blood count and differential, Metabolic profile and lactate dehydrogenase. An adequate skin biopsy is also important for evaluation and staging. Either 4-6 mm punch, incisional, or excisional biopsies should be obtained and should include the reticular dermis and subcutaneous fat. Superficial biopsy specimens may not differentiate PCBCL from reactive or inflammatory processes. Histologically, PCBCL shows a diffuse monotonous population of centroblasts and immunoblasts. Histochemistry tests are essential to classify the exact type of lymphoma. […] PCFCL needs to be differentiated from a secondary cutaneous lymphoma, which is where a nodal follicular lymphoma has spread to involve the skin. Cellular morphology may vary with the age and size of the lesion. Histologically, PCFCL shows: Dermal and subcutaneous proliferation of centrocytes (cleaved follicle centre cells) and centroblasts (large transformed cells) in a follicular and/or diffuse growth pattern. Immunostaining shows: Positive B-cell antigens, ie CD20 and CD79a, Negative bcl-2 protein, and, the t(14;18) translocation (which if present may suggest systemic follicular lymphoma), Negative immunoglobulin M expression.

• #39 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  How is primary cutaneous marginal zone lymphoma diagnosed? After obtaining a full history from the patient and performing a physical examination and skin examination, the diagnosis is made based on an adequate full-thickness biopsy of the affected skin. […] A 46 mm punch, incisional, or excisional biopsy should be obtained. The biopsy specimen should include the reticular dermis and fat. […] Histologically, cutaneous marginal zone lymphomas show nodular to diffuse dermal infiltration of marginal zone B-cells, lymphocytes, lymphoplasmacytoid cells, and plasma cells combined with centroblast- or immunoblast-like cells and reactive T cells. Marginal zone B cells are small to medium in size and have irregular nuclei, inconspicuous nucleoli, and abundant pale cytoplasm. […] Immunohistochemistry tests of cutaneous marginal zone lymphomas are positive for CD20, CD79a, and BCL-2, and negative for CD 10, and BCL-6 cells.

• #40 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  The work-up of PCBCL should include a complete history, physical and skin examination. Initial blood tests should include: Full blood count and differential, Metabolic profile and lactate dehydrogenase. An adequate skin biopsy is also important for evaluation and staging. Either 4-6 mm punch, incisional, or excisional biopsies should be obtained and should include the reticular dermis and subcutaneous fat. Superficial biopsy specimens may not differentiate PCBCL from reactive or inflammatory processes. Histologically, PCBCL shows a diffuse monotonous population of centroblasts and immunoblasts. Histochemistry tests are essential to classify the exact type of lymphoma. […] PCFCL needs to be differentiated from a secondary cutaneous lymphoma, which is where a nodal follicular lymphoma has spread to involve the skin. Cellular morphology may vary with the age and size of the lesion. Histologically, PCFCL shows: Dermal and subcutaneous proliferation of centrocytes (cleaved follicle centre cells) and centroblasts (large transformed cells) in a follicular and/or diffuse growth pattern. Immunostaining shows: Positive B-cell antigens, ie CD20 and CD79a, Negative bcl-2 protein, and, the t(14;18) translocation (which if present may suggest systemic follicular lymphoma), Negative immunoglobulin M expression.

• #41 Primary Cutaneous Diffuse Large B-Cell Lymphoma-Leg Type, a Convoluted Path to Diagnosis

  https://austinpublishinggroup.com/family-medicine/fulltext/jfm-v8-id1238.php

  Primary cutaneous diffuse large B cell lymphoma is a rare and aggressive form of primary cutaneous B-cell lymphoma. […] The diagnosis may initially be challenging to make, as the presentation often mimics other more common etiologies such as superficial thrombophlebitis and cellulitis. […] Diagnosis can be confirmed with the appropriate clinical picture and consistent immunohistological findings. […] After ruling out infectious and vascular etiologies she underwent bilateral skin biopsies, revealing primary cutaneous diffuse large B-cell lymphoma, leg type. […] Immunostaining was positive for CD20, PAX-5, BCL-2, BCL-6, and MUM-1. […] PCDLBCL-LT is a particularly aggressive form of lymphoma, especially if associated with BCL-2 positivity. […] With a lack of clinical data, and no specific clinical criteria to diagnose this rare disease, a high index of suspicion is needed.

• #42 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #43 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  The study of molecular rearrangements of genes encoding Ig heavy chains (IGH) is useful to differentiate PCBCL from pseudolymphomas. […] More recent studies performed by comparative genomic hybridization (CGH), using microarrays and subsequently confirmed by fluorescence in situ hybridization (FISH) enabled to detect a large number of recurring genetic aberrations in PCLBCL-leg type, and, although less frequently, in PCFCL with predominance of large cells; in contrast, they are rarely found in indolent PCFCL and PCMZL. […] In general, PCBCL have a more indolent clinical course and a more favorable prognosis than their nodal counterparts. […] Overall survival rate in 5 years for PCMZL and PCFCL is higher than 90%. In contrast, for PCLBCL, particularly leg type, prognosis is more guarded, with a survival rate in 5 years lower than 60%. […] Treatment should be selected taking into account the type of lymphoma and its stage, and should be adapted to risk. […] Several therapeutic modalities are available for PCBCL.

• #44

  https://medicaljournalssweden.se/actadv/article/view/11277

  A diagnosis of primary cutaneous B-cell lymphoma is mainly supported by identification of a monoclonal B-cell population in the skin. This identification is made either by immunohistochemistry techniques using monoclonal antibodies towards the lambda or kappa chains, or by PCR for the heavy chain of immunoglobulins. Immunohistochemistry has a low sensitivity in detecting monoclonality, whereas the PCR technique is sensitive, but does not permit the localization of tumour cells in the skin. The aim of this study was to determine whether a monoclonal population in the skin could be detected by in situ hybridization. Thirty-eight skin biopsies from patients with primary cutaneous B-cell lymphoma were studied. Monoclonality was observed in 24/38 (63%) biopsies using immunohistochemical methods and 32/38 (84%) when combining this with in situ hybridization. It is concluded that kappa or lambda chain in situ hybridization is an interesting complementary technique to detect monoclonal B cells, if the immunohistochemical technique is negative.

• #45 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #46 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #47 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  The study of molecular rearrangements of genes encoding Ig heavy chains (IGH) is useful to differentiate PCBCL from pseudolymphomas. […] More recent studies performed by comparative genomic hybridization (CGH), using microarrays and subsequently confirmed by fluorescence in situ hybridization (FISH) enabled to detect a large number of recurring genetic aberrations in PCLBCL-leg type, and, although less frequently, in PCFCL with predominance of large cells; in contrast, they are rarely found in indolent PCFCL and PCMZL. […] In general, PCBCL have a more indolent clinical course and a more favorable prognosis than their nodal counterparts. […] Overall survival rate in 5 years for PCMZL and PCFCL is higher than 90%. In contrast, for PCLBCL, particularly leg type, prognosis is more guarded, with a survival rate in 5 years lower than 60%. […] Treatment should be selected taking into account the type of lymphoma and its stage, and should be adapted to risk. […] Several therapeutic modalities are available for PCBCL.

• #48 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #49 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #50 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #51 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://community.the-hospitalist.org/content/what-your-diagnosis-cutaneous-b-cell-lymphoma

  For cutaneous lymphomas, except mycosis fungoides and Szary syndrome, the International Society for Cutaneous Lymphomas and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer recommends obtaining a complete blood cell count with differential; complete metabolic studies including lactate dehydrogenase; and imaging studies of the chest, abdomen, and pelvis. […] A bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #52 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #53 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #54 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #55 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #56 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://community.the-hospitalist.org/content/what-your-diagnosis-cutaneous-b-cell-lymphoma

  For cutaneous lymphomas, except mycosis fungoides and Szary syndrome, the International Society for Cutaneous Lymphomas and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer recommends obtaining a complete blood cell count with differential; complete metabolic studies including lactate dehydrogenase; and imaging studies of the chest, abdomen, and pelvis. […] A bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #57 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #58 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #59 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #60 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #61 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #62 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #63 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #64 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #65 Unveiling Primary Cutaneous B-Cell Lymphomas: New Insights into Diagnosis and Treatment Strategies

  https://www.mdpi.com/2072-6694/17/7/1202

  The prognosis is generally excellent, with a 5-year survival rate exceeding 95%; although remarkably rare, cases located on the legs have a strikingly lower 5-year survival rate of approximately 41%. […] The pathogenesis of PCMZL/LPD is thought to be linked to chronic antigenic stimulation, notably to Borrelia burgdorferi infection, although this association has been solely confirmed in a subset of patients from endemic areas in Europe. […] Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL,LT), first described in 1996, is an aggressive subtype of PCBCL that accounts for 1–4% of all PCL. This entity predominantly affects older adults, with a median age at diagnosis of approximately 70 years, and exhibits a marked female predominance, with a female-to-male ratio ranging from 2:1 to 3:1.

• #66 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #67 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #68 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #69 Primary Cutaneous B-cell Lymphoma | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/primary-cutaneous-b-cell-lymphoma

  Primary cutaneous B-cell lymphoma (CBCL) is a form of cancer that originates from B cells that present in the skin and nowhere else in the body, often referred to as an extranodal (outside the lymph node) non-Hodgkins lymphoma. […] To be diagnosed with a primary cutaneous B cell lymphoma, you must have no evidence of systemic (internal) disease, usually done by medical imaging of the body at the time of presentation. However, in cases with a classic clinical presentation and pathology findings on biopsy, imaging may not be needed. […] When a skin biopsy shows B-cell lymphoma it is very important to make sure that the lymphoma is truly coming from the skin, and not from a systemic lymphoma that has spread to the skin. It is also important that any diagnosis of CBCL is confirmed by a pathologist who has expertise in diagnosing cutaneous lymphomas.

• #70 Primary Cutaneous B-cell Lymphoma | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/primary-cutaneous-b-cell-lymphoma

  Primary cutaneous B-cell lymphoma (CBCL) is a form of cancer that originates from B cells that present in the skin and nowhere else in the body, often referred to as an extranodal (outside the lymph node) non-Hodgkins lymphoma. […] To be diagnosed with a primary cutaneous B cell lymphoma, you must have no evidence of systemic (internal) disease, usually done by medical imaging of the body at the time of presentation. However, in cases with a classic clinical presentation and pathology findings on biopsy, imaging may not be needed. […] When a skin biopsy shows B-cell lymphoma it is very important to make sure that the lymphoma is truly coming from the skin, and not from a systemic lymphoma that has spread to the skin. It is also important that any diagnosis of CBCL is confirmed by a pathologist who has expertise in diagnosing cutaneous lymphomas.

• #71 Lymphoma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html

  The diagnosis of lymphoma is made using an open lymph node biopsy, based off morphology, immunohistochemistry, and flow cytometry. […] Although fine-needle aspiration and core needle biopsy are often part of the initial evaluation of any adenopathy, neither will provide adequate tissue for the diagnosis of lymphoma because of the need to verify Hodgkin lymphoma via the presence of Reed-Sternberg cells. […] The Ann Arbor staging system was initially developed in 1971 for Hodgkin lymphoma, and was later adapted for non-Hodgkin lymphoma. The Lugano classification system further modified staging by incorporating positron emission tomography/computed tomography (PET-CT) results to determine the staging of the lymphoma. […] PET-CT is used for fluorodeoxyglucose-avid lymphoma subtypes, with symptoms alone being used for staging the remaining subtypes.

• #72 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #73 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #74 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  These results indicate that bone marrow investigation may be useful for staging patients with a PCFCL especially if it displays BCL-2 expression, whereas bone marrow examination appears to have limited value in patients with PCMZL. […] In summary, an appropriate diagnostic process has important implications for the management of patients with PCBCLs. The clinician starts with the diagnosis issued by the pathologist and may ask for additional molecular and/or microbiological investigations. The subsequent diagnostic work-up of PCBCLs should determine the extent of disease and can be achieved through a careful staging assessment which should be based on the biological behavior of the different subtype of PCBCLs, notably indolent or aggressive.

• #75 Lymphoma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html

  A bone marrow biopsy is now recommended only for diffuse large B-cell lymphoma with a negative PET-CT result. […] The International Prognostic Index is used broadly for all subtypes of non-Hodgkin lymphoma, and the International Prognostic Score is used for Hodgkin lymphoma. […] Treatment of lymphoma consists of chemotherapy alone or in combination with radiotherapy. […] The standard treatment for Hodgkin lymphoma is ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine [Velban], and dacarbazine), but other regimens such as the Stanford V (doxorubicin, vinblastine, mechlorethamine, etoposide [Toposar], vincristine, bleomycin, and prednisone) and escalated-BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine [Matulane], and prednisone) can be used. […] Treatment for non-Hodgkin lymphoma varies depending on the histology, but often uses treatments such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (Rituxan; R-CHOP), a monoclonal antibody specific for CD20-positive B lymphocytes.

• #76 Cutaneous marginal zone lymphoma

  https://dermnetnz.org/topics/cutaneous-marginal-zone-lymphoma

  Other essential investigations include a full blood count, comprehensive metabolic profile, and lactate dehydrogenase studies. A test for Borrelia burgdorferi may also be performed, particularly in endemic regions. […] Additional blood tests that may be performed for the evaluation and staging of the disease include antinuclear antibody, rapid plasma reagin, viral hepatitis serologies, flow cytometry, serum protein electrophoresis, and quantitative immunoglobulin evaluation. […] Imaging may include positron emission tomography (PET) and/or computed tomography (CT). […] Any lymph node with high PET activity, or measuring 1.5 cm in length by an imaging study, should be biopsied. A bone marrow biopsy is optional.

• #77 Early Detection of Cutaneous Lymphoma

  https://www.cancernetwork.com/view/early-detection-cutaneous-lymphoma

  Primary cutaneous follicle center cell lymphoma accounts for 40% of primary cutaneous B-cell lymphomas. […] Primary cutaneous follicle center cell lymphoma is characterized by plum-colored, firm, indurated nodules that have a smooth surface and lack scales. […] A thorough work-up of patients with cutaneous B-cell lymphoma will reveal extracutaneous involvement in about 25% of patients. […] Unlike cutaneous T-cell lymphoma, enlargement of peripheral lymph nodes in patients with cutaneous B-cell lymphoma usually indicates neoplastic infiltration as opposed to dermatopathic lymphadenopathy.

• #78 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://mdedge.com/cutis/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  The initial staging techniques that are preferred for cutaneous lymphomas have been debated. […] Although a more limited workup may be sufficient for PCBCLs such as primary cutaneous marginal zone lymphoma, a bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #79 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://mdedge.com/cutis/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  The initial staging techniques that are preferred for cutaneous lymphomas have been debated. […] Although a more limited workup may be sufficient for PCBCLs such as primary cutaneous marginal zone lymphoma, a bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #80 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge Dermatology

  https://www.mdedge9-ma1.mdedge.com/dermatology/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  Although a more limited workup may be sufficient for PCBCLs such as primary cutaneous marginal zone lymphoma, a bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype. […] Staining for antibodies against BCL-2, BCL-6, CD10, and MUM-1 also plays an important role in the diagnosis of cutaneous lymphoma and determining where the lesion(s) falls within the classification schemes.

• #81 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://mdedge.com/cutis/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  The initial staging techniques that are preferred for cutaneous lymphomas have been debated. […] Although a more limited workup may be sufficient for PCBCLs such as primary cutaneous marginal zone lymphoma, a bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #82 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://mdedge.com/cutis/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  The initial staging techniques that are preferred for cutaneous lymphomas have been debated. […] Although a more limited workup may be sufficient for PCBCLs such as primary cutaneous marginal zone lymphoma, a bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #83 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://mdedge.com/cutis/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  The initial staging techniques that are preferred for cutaneous lymphomas have been debated. […] Although a more limited workup may be sufficient for PCBCLs such as primary cutaneous marginal zone lymphoma, a bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #84 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://mdedge.com/cutis/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  The initial staging techniques that are preferred for cutaneous lymphomas have been debated. […] Although a more limited workup may be sufficient for PCBCLs such as primary cutaneous marginal zone lymphoma, a bone marrow biopsy is recommended for cases of primary cutaneous DLBCL (leg type). […] The differential diagnosis of CBCL includes cutaneous lymphoid hyperplasia (pseudolymphoma), which may be the result of insults such as arthropod bites, stings, vaccinations, or trauma. […] Histology for CBCL typically reveals an atypical lymphocytic infiltrate showing a CD20+ and CD79a+ immunophenotype.

• #85 Primary cutaneous B cell lymphoma: Clinical features, diagnosis and treatment

  https://www.wjgnet.com/2218-6190/full/v4/i1/50.htm

  The differentiation of PCMZL from reactive skin changes and other cutaneous lymphomas is important. Morphologic and immunophenotypic features and demonstration of clonality will aid in the differential diagnosis. […] The diagnosis is based on the histological and immunohistochemical examination of biopsy material and ruling out the systemic disease. PCFCL shows nodular or diffuse infiltration of the dermis and subcutaneous tissue; sparing of the epidermis is almost a rule. […] In patients with very extensive skin lesions, systemic rituximab is the first choice of treatment. Rituximab, systemic or intralesional, have been used in limited number of patients with PCFCL in the literature. […] The differential diagnosis especially from PCFCL is important; PCFCL typically comprises centrocytes which don’t express bcl2 or MUM1 in contrast to PCLBCL – LT. […] The diagnosis is difficult because of divergent clinical presentation and absence of lymphadenopathy. Random skin biopsy is beneficial for early diagnosis in ILCL.

• #86 Primary cutaneous B cell lymphoma: Clinical features, diagnosis and treatment

  https://www.wjgnet.com/2218-6190/full/v4/i1/50.htm

  The differentiation of PCMZL from reactive skin changes and other cutaneous lymphomas is important. Morphologic and immunophenotypic features and demonstration of clonality will aid in the differential diagnosis. […] The diagnosis is based on the histological and immunohistochemical examination of biopsy material and ruling out the systemic disease. PCFCL shows nodular or diffuse infiltration of the dermis and subcutaneous tissue; sparing of the epidermis is almost a rule. […] In patients with very extensive skin lesions, systemic rituximab is the first choice of treatment. Rituximab, systemic or intralesional, have been used in limited number of patients with PCFCL in the literature. […] The differential diagnosis especially from PCFCL is important; PCFCL typically comprises centrocytes which don’t express bcl2 or MUM1 in contrast to PCLBCL – LT. […] The diagnosis is difficult because of divergent clinical presentation and absence of lymphadenopathy. Random skin biopsy is beneficial for early diagnosis in ILCL.

• #87 Primary cutaneous B cell lymphoma: Clinical features, diagnosis and treatment

  https://www.wjgnet.com/2218-6190/full/v4/i1/50.htm

  The differentiation of PCMZL from reactive skin changes and other cutaneous lymphomas is important. Morphologic and immunophenotypic features and demonstration of clonality will aid in the differential diagnosis. […] The diagnosis is based on the histological and immunohistochemical examination of biopsy material and ruling out the systemic disease. PCFCL shows nodular or diffuse infiltration of the dermis and subcutaneous tissue; sparing of the epidermis is almost a rule. […] In patients with very extensive skin lesions, systemic rituximab is the first choice of treatment. Rituximab, systemic or intralesional, have been used in limited number of patients with PCFCL in the literature. […] The differential diagnosis especially from PCFCL is important; PCFCL typically comprises centrocytes which don’t express bcl2 or MUM1 in contrast to PCLBCL – LT. […] The diagnosis is difficult because of divergent clinical presentation and absence of lymphadenopathy. Random skin biopsy is beneficial for early diagnosis in ILCL.

• #88 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  The work-up of PCBCL should include a complete history, physical and skin examination. Initial blood tests should include: Full blood count and differential, Metabolic profile and lactate dehydrogenase. An adequate skin biopsy is also important for evaluation and staging. Either 4-6 mm punch, incisional, or excisional biopsies should be obtained and should include the reticular dermis and subcutaneous fat. Superficial biopsy specimens may not differentiate PCBCL from reactive or inflammatory processes. Histologically, PCBCL shows a diffuse monotonous population of centroblasts and immunoblasts. Histochemistry tests are essential to classify the exact type of lymphoma. […] PCFCL needs to be differentiated from a secondary cutaneous lymphoma, which is where a nodal follicular lymphoma has spread to involve the skin. Cellular morphology may vary with the age and size of the lesion. Histologically, PCFCL shows: Dermal and subcutaneous proliferation of centrocytes (cleaved follicle centre cells) and centroblasts (large transformed cells) in a follicular and/or diffuse growth pattern. Immunostaining shows: Positive B-cell antigens, ie CD20 and CD79a, Negative bcl-2 protein, and, the t(14;18) translocation (which if present may suggest systemic follicular lymphoma), Negative immunoglobulin M expression.

• #89

  https://www.pagepress.org/journals/index.php/dr/article/view/9723

  Of all cutaneous lymphomas, 25% are primary cutaneous B-cell lymphomas (PCBCLs). Of these, primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous marginal zone B-cell lymphoma (PCMZL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT) are the most common subtypes. For the diagnosis of PCBCLs, a biopsy combined with immunohistochemistry and histological examination is the gold standard. […] PCDLBCL-LT has an aggressive course that spreads to extracutaneous sites in about 45% of cases, whereas PCFCL and PCMZL are indolent diseases. As a result, instrumental staging is advised for PCDLBCL-LT but not for extracutaneous disease after a diagnosis of PCMZL or PCFCL. Lastly, dermatoscopy may offer a novel diagnostic tool to improve the clinical recognition of various PCBCL subtypes when used in conjunction with a strong clinical suspicion.

• #90 Cutaneous B-cell lymphoma – dermoscopedia

  https://dermoscopedia.org/Cutaneous_B-cell_lymphoma

  Only few studies evaluated the diagnostic value of dermoscopy in cutaneous B-cell lymphomas. Dermoscopy can assist in distinguishing between cutaneous B-cell lymphoma and other differential diagnoses that present as solitary or grouped pink lesions. […] Primary cutaneous B-cell lymphomas are classified into 3 main types: primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma leg type, and all three types show similar dermoscopic characteristics. […] Although not specific, the most common dermoscopic features are salmon-colored background/area and blood vessels, most frequently serpentine (linear irregular) vessels.

• #91 Diffuse Systemic Large B-Cell Lymphoma With Secondary Skin Involvement | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-diffuse-systemic-large-b-cell-lymphoma-articulo-S1578219015002097

  The primary cutaneous variant of DLBCL, primary cutaneous diffuse large B-cell lymphoma (PCDLBCL), leg type, is one of the 3 most common types of primary cutaneous B-cell lymphomas, together with primary cutaneous follicle center lymphoma and marginal zone B-cell lymphoma. PCDLBCL, leg-type presents as solitary or multiple violaceous plaques that typically occur on the legs of elderly patients. It is by far the primary cutaneous B-cell lymphoma with the worst prognosis, with a 5-year survival of 50%. It is therefore essential to initiate treatment with multi-agent chemotherapy and rituximab as early as possible. […] Because the immunohistochemical markers are the same for PCDLBCL, leg type and its systemic variant, DLBCL, according to the current WHO-EORTC criteria, definitive diagnosis should be based on the presence or absence of extracutaneous disease at diagnosis.

• #92 Diffuse Systemic Large B-Cell Lymphoma With Secondary Skin Involvement | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-diffuse-systemic-large-b-cell-lymphoma-articulo-S1578219015002097

  The primary cutaneous variant of DLBCL, primary cutaneous diffuse large B-cell lymphoma (PCDLBCL), leg type, is one of the 3 most common types of primary cutaneous B-cell lymphomas, together with primary cutaneous follicle center lymphoma and marginal zone B-cell lymphoma. PCDLBCL, leg-type presents as solitary or multiple violaceous plaques that typically occur on the legs of elderly patients. It is by far the primary cutaneous B-cell lymphoma with the worst prognosis, with a 5-year survival of 50%. It is therefore essential to initiate treatment with multi-agent chemotherapy and rituximab as early as possible. […] Because the immunohistochemical markers are the same for PCDLBCL, leg type and its systemic variant, DLBCL, according to the current WHO-EORTC criteria, definitive diagnosis should be based on the presence or absence of extracutaneous disease at diagnosis.

• #93 Diffuse Systemic Large B-Cell Lymphoma With Secondary Skin Involvement | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-diffuse-systemic-large-b-cell-lymphoma-articulo-S1578219015002097

  The primary cutaneous variant of DLBCL, primary cutaneous diffuse large B-cell lymphoma (PCDLBCL), leg type, is one of the 3 most common types of primary cutaneous B-cell lymphomas, together with primary cutaneous follicle center lymphoma and marginal zone B-cell lymphoma. PCDLBCL, leg-type presents as solitary or multiple violaceous plaques that typically occur on the legs of elderly patients. It is by far the primary cutaneous B-cell lymphoma with the worst prognosis, with a 5-year survival of 50%. It is therefore essential to initiate treatment with multi-agent chemotherapy and rituximab as early as possible. […] Because the immunohistochemical markers are the same for PCDLBCL, leg type and its systemic variant, DLBCL, according to the current WHO-EORTC criteria, definitive diagnosis should be based on the presence or absence of extracutaneous disease at diagnosis.

• #94 Diffuse Systemic Large B-Cell Lymphoma With Secondary Skin Involvement | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-diffuse-systemic-large-b-cell-lymphoma-articulo-S1578219015002097

  The primary cutaneous variant of DLBCL, primary cutaneous diffuse large B-cell lymphoma (PCDLBCL), leg type, is one of the 3 most common types of primary cutaneous B-cell lymphomas, together with primary cutaneous follicle center lymphoma and marginal zone B-cell lymphoma. PCDLBCL, leg-type presents as solitary or multiple violaceous plaques that typically occur on the legs of elderly patients. It is by far the primary cutaneous B-cell lymphoma with the worst prognosis, with a 5-year survival of 50%. It is therefore essential to initiate treatment with multi-agent chemotherapy and rituximab as early as possible. […] Because the immunohistochemical markers are the same for PCDLBCL, leg type and its systemic variant, DLBCL, according to the current WHO-EORTC criteria, definitive diagnosis should be based on the presence or absence of extracutaneous disease at diagnosis.

• #95 Diffuse Systemic Large B-Cell Lymphoma With Secondary Skin Involvement | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-diffuse-systemic-large-b-cell-lymphoma-articulo-S1578219015002097

  The primary cutaneous variant of DLBCL, primary cutaneous diffuse large B-cell lymphoma (PCDLBCL), leg type, is one of the 3 most common types of primary cutaneous B-cell lymphomas, together with primary cutaneous follicle center lymphoma and marginal zone B-cell lymphoma. PCDLBCL, leg-type presents as solitary or multiple violaceous plaques that typically occur on the legs of elderly patients. It is by far the primary cutaneous B-cell lymphoma with the worst prognosis, with a 5-year survival of 50%. It is therefore essential to initiate treatment with multi-agent chemotherapy and rituximab as early as possible. […] Because the immunohistochemical markers are the same for PCDLBCL, leg type and its systemic variant, DLBCL, according to the current WHO-EORTC criteria, definitive diagnosis should be based on the presence or absence of extracutaneous disease at diagnosis.

• #96 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://mdedge.com/cutis/article/88558/nonmelanoma-skin-cancer/what-your-diagnosis-cutaneous-b-cell-lymphoma

  A 59-year-old white man presented with 2 large erythematous lesions on the right side of the chest wall that had gradually progressed over the last 1.5 years. […] The Diagnosis: Cutaneous B-cell Lymphoma […] Biopsies from the right side of the chest wall revealed an atypical dense and diffuse lymphocytic infiltrate throughout the dermis. […] However, the findings were consistent with cutaneous B-cell lymphoma (CBCL), and the diffuse large B-cell type was favored. […] A preliminary diagnosis of primary CBCL (PCBCL) was formulated. […] In general, CBCL tends to affect adults and presents as relatively firm and plum-colored papules, nodules, tumors, or plaques, which can be either fast or slow growing. Cutaneous B-cell lymphoma may be primary or secondary to systemic involvement. […] Detecting systemic involvement and distinguishing between PCBCL and SCBCL is valuable in determining prognosis and therapeutic options, as subtypes of PCBCL often have an improved prognosis and may be treated with local irradiation.

• #97 OBTAINING A PROPER CUTANEOUS LYMPHOMA DIAGNOSIS | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/obtaining-proper-cutaneous-lymphoma-diagnosis

  One of the most difficult things about uncommon diseases for both patients and physicians is reaching a correct diagnosis. […] A definitive diagnosis will help inform treatment decisions and potentially yield better patient-related outcomes over time. […] In the case of cutaneous lymphoma, a definitive diagnosis sometimes takes years. […] Since reactive processes and other types of inflammation can trigger symptoms similar to those of cutaneous lymphomas, evaluation by a provider with experience in diagnosing skin lymphoma is important if skin lymphoma is suspected. […] A definitive diagnosis cannot be obtained without a biopsy, and multiple biopsies are often necessary to confirm the diagnosis of cutaneous lymphoma. […] It is very important to confirm any diagnosis of cutaneous lymphoma by a specialized type of pathologist – dermatopathologist or a hematopathologist – who has expertise in diagnosing cutaneous lymphomas.

• #98 Cutaneous B-Cell Lymphoma: Symptoms, Treatment, and Diagnosis | MyLymphomaTeam

  https://www.mylymphomateam.com/resources/cutaneous-b-cell-lymphoma

  Cutaneous B-cell lymphoma (CBCL) is a rare type of non-Hodgkin lymphoma that develops in the B lymphocytes (or B cells) and affects the skin hence the term cutaneous. […] Diagnosing cutaneous B-cell lymphoma can take months or years from the time the nodules or rash first appears. CBCL can mimic the appearance of many other skin conditions. A skin biopsy the removal and testing of a small sample of tissue is usually required to diagnose CBCL. […] Because of this, it may take several biopsies over the course of many years before a diagnosis of cutaneous B-cell lymphoma is confirmed. […] Other tests and procedures used to diagnose cutaneous B-cell lymphoma include: A physical exam Your doctor will examine your skin, check for swollen lymph nodes, and ask about other symptoms. Blood tests Blood tests for lymphoma involve analyzing a sample of your blood for the presence of lymphoma cells. Imaging tests Your doctor may use images from computerized tomography (CT) and positron emission tomography (PET) scans to help diagnose lymphoma. Bone marrow biopsy A sample of your bone marrow is collected with a needle and tested for the presence of lymphoma cells. […] Staging is determined during the diagnostic process for CBCL.

• #99 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #100 Unveiling Primary Cutaneous B-Cell Lymphomas: New Insights into Diagnosis and Treatment Strategies

  https://www.mdpi.com/2072-6694/17/7/1202

  This narrative review synthesizes current literature on the clinical, morphologic, immunohistochemical, and molecular characteristics of PCBCL. It also evaluates the diagnostic utility of immunohistochemistry, gene expression profiling, and molecular assays, particularly in distinguishing primary cutaneous disease from secondary cutaneous involvement by systemic lymphomas. […] Diagnosis and management remain challenging for clinicians. […] PCBCL encompass distinct clinicopathologic entities with subtype-specific diagnostic and therapeutic considerations. While current management is guided by clinical behavior, significant knowledge gaps remain regarding the molecular mechanisms underlying skin tropism, immune evasion, and disease progression. Future research could focus on improving molecular characterization and developing personalized and immune-based therapies to enhance outcomes.

• #101 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #102 How to Recognize Skin Lymphoma Symptoms

  https://www.verywellhealth.com/skin-lymphoma-symptoms-5218265

  Skin lymphomas are usually identified in the early stages. However, diagnosis can be delayed since skin lymphomas mimic other skin conditions. […] Once a skin lymphoma is suspected, the steps to diagnosis include: […] Skin lymphomas are often misdiagnosed as dermatitis, psoriasis, eczema, or skin infections. […] Although it’s stressful waiting for the test results, it’s important to know what type of skin lymphoma you have and whether it has traveled to other parts of your body.

• #103 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #104 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  The treatments for some of these other conditions (for example, steroid creams) can also be used to treat skin lymphoma. This means that even if you are treated for a different condition, your skin might improve for a while. This may delay the time it takes before a skin lymphoma is suspected. Some people make many visits to the GP or skin clinic before getting a final diagnosis. […] If your specialist feels that treatment would help you, there are many different options. Some treatments are applied directly to affected areas of your skin (topical treatment), such as creams, lotions or ointments, light therapy or radiotherapy. Other treatment affects your whole body (systemic treatment), such as immunotherapy (drugs that use your own immune system to help your body get rid of lymphoma cells), steroids, chemotherapy or, rarely, a stem cell transplant. […] If you have been diagnosed with skin lymphoma, you can find more detail on the treatment you might have on our pages about specific skin lymphomas: cutaneous T-cell lymphomas (CTCLs), including mycosis fungoides and Szary syndrome, cutaneous B-cell lymphomas (CBCLs).

• #105 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #106 Dermoscopy in the diagnosis of cutaneous lymphoma (Review)

  https://www.spandidos-publications.com/10.3892/etm.2022.11304

  Cutaneous lymphomas are a group of rare and distinct diseases that present varying clinical manifestations, histopathology and prognosis. Optimal and early management relies on accurate diagnosis. Unfortunately, clinical diagnosis in early stages is difficult due to the clinical overlap with other dermatologic conditions. […] Studies have shown that dermoscopy may be useful in the evaluation of cutaneous lymphomas, offering a link between clinical and histopathological examination, but the features are not diagnostic and histopathological confirmation is mandatory. However, dermoscopy can raise suspicion of cancer, leading to a skin biopsy. Furthermore, larger and prospective studies are required to define the exact dermoscopic features of every subtype of cutaneous lymphoma. […] Optimal and early management of cutaneous lymphoma relies on accurate diagnosis. Unfortunately, clinical diagnosis, particularly in early stages is difficult to establish due to the clinical overlap with inflammatory conditions. In addition, histopathological diagnosis can be challenging as well due to absence of explicit diagnostic characteristics and a classification that frequently changes.

• #107 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #108 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #109 Skin lymphomas – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/lymphoma/non-hodgkin-lymphoma/skin-lymphomas/

  Cutaneous lymphomas are diseases that often require input from several professionals (e.g. pathologists, doctors, nurses) in order to reach a diagnosis and to manage the condition. […] Most people begin by going to see their GP with symptoms. If your doctor has concerns that you may have symptoms of a skin lymphoma they will refer you to a dermatologist or haematologist who may perform a biopsy. This means having a sample taken of the affected area that will be examined under a microscope to see if it contains cancer cells. If it does, you will need to have further tests. […] CBCL is a general term for B-cell lymphomas that involve the skin. Some B-cell lymphomas found on the skin may come from within the body but involve the skin. Therefore it is important when a skin biopsy shows a B-cell lymphoma that further tests are carried out to make sure other areas of the body are not involved and that the disease has originated in the skin.

• #110 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #111 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #112 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #113 OBTAINING A PROPER CUTANEOUS LYMPHOMA DIAGNOSIS | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/obtaining-proper-cutaneous-lymphoma-diagnosis

  One of the most difficult things about uncommon diseases for both patients and physicians is reaching a correct diagnosis. […] A definitive diagnosis will help inform treatment decisions and potentially yield better patient-related outcomes over time. […] In the case of cutaneous lymphoma, a definitive diagnosis sometimes takes years. […] Since reactive processes and other types of inflammation can trigger symptoms similar to those of cutaneous lymphomas, evaluation by a provider with experience in diagnosing skin lymphoma is important if skin lymphoma is suspected. […] A definitive diagnosis cannot be obtained without a biopsy, and multiple biopsies are often necessary to confirm the diagnosis of cutaneous lymphoma. […] It is very important to confirm any diagnosis of cutaneous lymphoma by a specialized type of pathologist – dermatopathologist or a hematopathologist – who has expertise in diagnosing cutaneous lymphomas.

• #114 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #115 Skin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma/skin-lymphoma

  Skin lymphoma is difficult to diagnose as it can develop slowly, sometimes over decades, and often resembles more common skin conditions. […] The most important test for diagnosing a skin lymphoma is a skin biopsy. The doctor numbs an affected area of your skin with a local anaesthetic and removes a small sample. This is sent to the laboratory to be examined under a microscope and for specialised genetic tests. […] Even if your doctor suspects a skin lymphoma, you may need to have tests repeated several times before the diagnosis is confirmed. On average it takes around three years to get a confirmed diagnosis of skin lymphoma. However, it might take considerably more or less time. […] Diagnosing skin lymphoma is a bit like solving a jigsaw puzzle. A team of people from different hospital departments are involved in identifying the pieces and putting them together. This might include a dermatologist (skin specialist), haematologist (a specialist in diseases of the blood, including lymphoma), or clinical oncologist who specialises in lymphoma (a specialist in treating people who have lymphoma with treatments that dont involve surgery) and other healthcare professionals, who work as part of a multidisciplinary team (MDT).

• #116

  https://link.springer.com/article/10.1007/s40257-022-00704-0

  Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. […] Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. […] To date, treatment recommendations for primary cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. […] An accurate pathologic diagnosis of the subtype is the most important first step in the management of pCBCLs. […] To appropriately confirm the diagnosis of pCBCL, systemic involvement must be ruled out. […] Management of pCBCL is complex and requires coordination of a multidisciplinary care team comprising dermatologists, pathologists, hematology-oncologists, and radiation oncologists. […] This review aims to describe the pathophysiological, epidemiological, clinicopathological, immunohistochemical, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management.

• #117 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  These results indicate that bone marrow investigation may be useful for staging patients with a PCFCL especially if it displays BCL-2 expression, whereas bone marrow examination appears to have limited value in patients with PCMZL. […] In summary, an appropriate diagnostic process has important implications for the management of patients with PCBCLs. The clinician starts with the diagnosis issued by the pathologist and may ask for additional molecular and/or microbiological investigations. The subsequent diagnostic work-up of PCBCLs should determine the extent of disease and can be achieved through a careful staging assessment which should be based on the biological behavior of the different subtype of PCBCLs, notably indolent or aggressive.

• #118 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #119 Primary cutaneous B cell lymphoma: Clinical features, diagnosis and treatment

  https://www.wjgnet.com/2218-6190/full/v4/i1/50.htm

  Primary cutaneous B cell lymphoma (PCBCL) is defined as B cell lymphomas that present in the skin without any evidence of extra-cutaneous involvement at diagnosis. They are the second most common type of PCL, accounting for 25%-30%. Since the prognosis and treatment differ from systemic lymphomas involving the skin, differential diagnosis becomes crucial. […] PCBCL is a heterogeneous group of diseases consisting different B cell lymphomas with distinct treatment and prognosis. Their clinical presentation is relatively uniform, mostly manifested by nodules. […] An adequate biopsy of the lesion, preferably excisional biopsy or a punch biopsy of at least 4 mm for routine histology and immunohistology is crucial for the diagnosis of PCL. […] The diagnosis of the disease can be established by histopathologic examination of the skin biopsy and exclusion of a systemic disease. Excisional biopsy is preferred but if an excisional biopsy is not appropriate, it can be substituted by a punch biopsy of an adequate length.

• #120 Immunophenotypic Diagnosis of Primary Cutaneous Lymphomas: A Review for the Practicing Dermatologist | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/immunophenotypic-diagnosis-of-primary-cutaneous-lymphomas-a-review-for-the-practicing-dermatologist-2/

  The first step in the immunophenotypic evaluation of these cases is determination if the dominant population of cells are B-cells, T-cells, or neither. […] Three markers are typically used for this initial classification: CD20, CD3, and CD45. […] If the lymphocytic proliferation stains positive with CD20, a B-cell immunophenotypic work-up is warranted and includes CD5, CD10, CD43, CD79a, Bcl-2, and Bcl-6. […] For cutaneous B-cell lymphomas, the predominant cell type is also identified based on morphological characteristics to aid in diagnosis. […] A patient diagnosed with cutaneous B-cell lymphoma must undergo a complete systemic work-up with a thorough review of systems, physical examination, and studies that include computed tomography scans and bone marrow biopsy, to determine if the B-cell lymphoma is primary or if it is a systemic B-cell lymphoma involving the skin secondarily.

• #121 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, limited to the skin, with no evidence of extracutaneous disease at the time of diagnosis. […] PCBCLs must be distinguished from nodal or systemic malignant lymphomas involving the skin secondarily, which are characterized by different clinical behavior and prognosis, and require distinct therapeutic approaches. Thus, a correct staging workup is mandatory for an appropriate management. […] According to these recommendations, an accurate staging should begin with a complete assessment of systemic symptoms and a physical examination. In every case blood tests should be performed, including a complete blood count with leukocyte differential, liver and kidney function analysis, serum levels of beta-2-microglobulin and lactate dehydrogenase (LDH).

• #122 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #123 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  Detection of chromosomal abnormalities in PCBCLs may be also useful for diagnosis, prognosis and therapy and it is generally performed using fluorescent in situ hybridization (FISH). […] Therefore, it may be useful to perform MYC-FISH in all newly diagnosed PCLBCL-LT. […] An appropriate imaging study should be performed in all patients with PCBCLs and includes either a chest, abdominal and pelvic computerized tomography (CT) scan with contrast or a whole body positron emission tomography (PET) technique together with CT scan, PET/CT scan. […] Next step in staging PCBCLs is the bone marrow biopsy, but the role of this diagnostic tool is controversial. […] According to the WHO-EORTC classification guidelines a bone marrow biopsy is indicated for PCLCL-LT because of the potential risk of extracutaneous spread, whereas it is optional in patients with PCMZL and PCFCL which have instead an indolent clinical behavior with a very low risk of dissemination.

• #124 OBTAINING A PROPER CUTANEOUS LYMPHOMA DIAGNOSIS | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/obtaining-proper-cutaneous-lymphoma-diagnosis

  Accuracy in determining whether a patient has cutaneous lymphoma, and which subset, is paramount in determining the best course of care and treatment. […] If a patient is ever dissatisfied with their diagnosis, they should seek a second opinion, conduct research and visit a cancer center that sees a high volume of cutaneous lymphoma patients.

• #125 Skin Lymphoma > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/skin-lymphoma

  Because skin lymphomas are rare, they can be particularly hard to diagnose and classify. Biopsies may be sent to a major medical center that has specific and extensive expertise in diagnosing the condition. […] Yale Medicine is one such center. We have dermatopathologists who are pathologists specializing in skin pathology, Dr. Wilson says. And theyre very subspecialized. They are very good at determining what is skin lymphoma and what isnt.

• #126 OBTAINING A PROPER CUTANEOUS LYMPHOMA DIAGNOSIS | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/obtaining-proper-cutaneous-lymphoma-diagnosis

  Accuracy in determining whether a patient has cutaneous lymphoma, and which subset, is paramount in determining the best course of care and treatment. […] If a patient is ever dissatisfied with their diagnosis, they should seek a second opinion, conduct research and visit a cancer center that sees a high volume of cutaneous lymphoma patients.

• #127 OBTAINING A PROPER CUTANEOUS LYMPHOMA DIAGNOSIS | Cutaneous Lymphoma Foundation

  https://www.clfoundation.org/obtaining-proper-cutaneous-lymphoma-diagnosis

  Accuracy in determining whether a patient has cutaneous lymphoma, and which subset, is paramount in determining the best course of care and treatment. […] If a patient is ever dissatisfied with their diagnosis, they should seek a second opinion, conduct research and visit a cancer center that sees a high volume of cutaneous lymphoma patients.

• #128 Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician’s Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7324640/

  These results indicate that bone marrow investigation may be useful for staging patients with a PCFCL especially if it displays BCL-2 expression, whereas bone marrow examination appears to have limited value in patients with PCMZL. […] In summary, an appropriate diagnostic process has important implications for the management of patients with PCBCLs. The clinician starts with the diagnosis issued by the pathologist and may ask for additional molecular and/or microbiological investigations. The subsequent diagnostic work-up of PCBCLs should determine the extent of disease and can be achieved through a careful staging assessment which should be based on the biological behavior of the different subtype of PCBCLs, notably indolent or aggressive.

• #129 Cutaneous B-Cell Lymphoma: Overview, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1099540-overview

  Cutaneous lymphomas represent a unique group of lymphomas and are the second most frequent extranodal lymphomas. They can be defined as lymphoproliferative skin infiltrates of T-cell, B-cell, or natural killer cell lineage, which primarily occur in and remain confined to the skin in most patients, without detectable extracutaneous manifestations at diagnosis. […] B-cell lymphomas account for the majority of nodal lymphomas, whereas primary cutaneous B-cell lymphomas (CBCLs) represent 20-25% of all cutaneous lymphomas. Because CBCLs have an overall favorable prognosis, proper recognition is vital for appropriate therapy and to avoid overtreatment in most cases. The tumor type and the extent of cutaneous involvement are the 2 most relevant prognostic factors in primary CBCL. […] The diagnosis of CBCL is established by analysis of skin biopsy specimen, using histomorphology and cytomorphology, immunohistochemistry and phenotypic features, and genotyping and cytogenetic studies.

• #130 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  The study of molecular rearrangements of genes encoding Ig heavy chains (IGH) is useful to differentiate PCBCL from pseudolymphomas. […] More recent studies performed by comparative genomic hybridization (CGH), using microarrays and subsequently confirmed by fluorescence in situ hybridization (FISH) enabled to detect a large number of recurring genetic aberrations in PCLBCL-leg type, and, although less frequently, in PCFCL with predominance of large cells; in contrast, they are rarely found in indolent PCFCL and PCMZL. […] In general, PCBCL have a more indolent clinical course and a more favorable prognosis than their nodal counterparts. […] Overall survival rate in 5 years for PCMZL and PCFCL is higher than 90%. In contrast, for PCLBCL, particularly leg type, prognosis is more guarded, with a survival rate in 5 years lower than 60%. […] Treatment should be selected taking into account the type of lymphoma and its stage, and should be adapted to risk. […] Several therapeutic modalities are available for PCBCL.

• #131 Primary Cutaneous B-Cell Lymphoma: An Update on Pathologic and Molecular Features

  https://www.mdpi.com/2673-6357/3/2/23

  In spite of these classificational advances, the diagnosis of PCBCL can be challenging and some issues are still a matter of debate. […] The distinction of PCMZL from other PCBCLs requires the careful evaluation of a series of cytological and architectural features combined with a proper immunohistochemical panel. […] The prognosis of PCMZL is excellent, with a five-year survival rate of 98%. […] PCDLBCL-LT is an aggressive disease with a five-year, disease-specific survival rate of around 50%, and many patients experience relapse despite treatment. […] The precise definition of the COO of this lymphoma is still incomplete and its mutational profile seems to be more similar to those of primary DLBCL of the central nervous system and primary testicular DLBCL.

• #132 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  Without any treatment, PCFCL lesions may be stable, gradually enlarge, or rarely, regress. The histological growth pattern does not influence survival or treatment choice. If PCFCL presents with a solitary lesion or is limited to a single site, treatment involves radiation therapy or surgery. Skin recurrences are common and often are outside the treated site but these do not affect prognosis. […] The recommended therapies for PCMZL are similar to PCFCL. Radiotherapy is highly effective and potentially curative for solitary or few contiguous lesions, but the relapse rates of PCMZL can be higher than PCFCL. […] Localised or solitary leg-type B-cell lymphoma is usually treated with local radiotherapy alone or in conjunction with R-CHOP. Generalised PCDLBCL-LT can be treated with R-CHOP and/or local radiotherapy. […] 5-year survival rates are around 95% for PCFCL. 5-year disease-specific survival of PCMZL is up to 99%. PCDLBCL-LT frequently disseminates to extracutaneous sites and has a poor prognosis in spite of aggressive therapy. 5-year survival rates are approximately 50%.

• #133 Primary Cutaneous B-Cell Lymphoma: An Update on Pathologic and Molecular Features

  https://www.mdpi.com/2673-6357/3/2/23

  In spite of these classificational advances, the diagnosis of PCBCL can be challenging and some issues are still a matter of debate. […] The distinction of PCMZL from other PCBCLs requires the careful evaluation of a series of cytological and architectural features combined with a proper immunohistochemical panel. […] The prognosis of PCMZL is excellent, with a five-year survival rate of 98%. […] PCDLBCL-LT is an aggressive disease with a five-year, disease-specific survival rate of around 50%, and many patients experience relapse despite treatment. […] The precise definition of the COO of this lymphoma is still incomplete and its mutational profile seems to be more similar to those of primary DLBCL of the central nervous system and primary testicular DLBCL.

• #134 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  Without any treatment, PCFCL lesions may be stable, gradually enlarge, or rarely, regress. The histological growth pattern does not influence survival or treatment choice. If PCFCL presents with a solitary lesion or is limited to a single site, treatment involves radiation therapy or surgery. Skin recurrences are common and often are outside the treated site but these do not affect prognosis. […] The recommended therapies for PCMZL are similar to PCFCL. Radiotherapy is highly effective and potentially curative for solitary or few contiguous lesions, but the relapse rates of PCMZL can be higher than PCFCL. […] Localised or solitary leg-type B-cell lymphoma is usually treated with local radiotherapy alone or in conjunction with R-CHOP. Generalised PCDLBCL-LT can be treated with R-CHOP and/or local radiotherapy. […] 5-year survival rates are around 95% for PCFCL. 5-year disease-specific survival of PCMZL is up to 99%. PCDLBCL-LT frequently disseminates to extracutaneous sites and has a poor prognosis in spite of aggressive therapy. 5-year survival rates are approximately 50%.

• #135 Primary Cutaneous B-Cell Lymphoma: An Update on Pathologic and Molecular Features

  https://www.mdpi.com/2673-6357/3/2/23

  In spite of these classificational advances, the diagnosis of PCBCL can be challenging and some issues are still a matter of debate. […] The distinction of PCMZL from other PCBCLs requires the careful evaluation of a series of cytological and architectural features combined with a proper immunohistochemical panel. […] The prognosis of PCMZL is excellent, with a five-year survival rate of 98%. […] PCDLBCL-LT is an aggressive disease with a five-year, disease-specific survival rate of around 50%, and many patients experience relapse despite treatment. […] The precise definition of the COO of this lymphoma is still incomplete and its mutational profile seems to be more similar to those of primary DLBCL of the central nervous system and primary testicular DLBCL.

• #136 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  Without any treatment, PCFCL lesions may be stable, gradually enlarge, or rarely, regress. The histological growth pattern does not influence survival or treatment choice. If PCFCL presents with a solitary lesion or is limited to a single site, treatment involves radiation therapy or surgery. Skin recurrences are common and often are outside the treated site but these do not affect prognosis. […] The recommended therapies for PCMZL are similar to PCFCL. Radiotherapy is highly effective and potentially curative for solitary or few contiguous lesions, but the relapse rates of PCMZL can be higher than PCFCL. […] Localised or solitary leg-type B-cell lymphoma is usually treated with local radiotherapy alone or in conjunction with R-CHOP. Generalised PCDLBCL-LT can be treated with R-CHOP and/or local radiotherapy. […] 5-year survival rates are around 95% for PCFCL. 5-year disease-specific survival of PCMZL is up to 99%. PCDLBCL-LT frequently disseminates to extracutaneous sites and has a poor prognosis in spite of aggressive therapy. 5-year survival rates are approximately 50%.

• #137 What Is Your Diagnosis? Cutaneous B-cell Lymphoma | MDedge

  https://community.the-hospitalist.org/content/what-your-diagnosis-cutaneous-b-cell-lymphoma

  The natural history and therapeutic options differ greatly between subtypes of CBCL. […] The prognosis of primary cutaneous follicle center lymphoma is generally favorable with a 5-year disease-specific survival rate of roughly 95%, and radiation therapy is recommended as a first-line therapy for localized disease. […] Conversely, primary cutaneous DLBCL (leg type) frequently spreads to extracutaneous sites and carries a much lower estimated 5-year disease-specific survival rate of 55%. […] Although it is uncertain whether the cutaneous lesions preceded systemic disease in our patient, the cutaneous lesions could be arbitrarily classified as secondary because extracutaneous disease was discovered within 6 months of the initial diagnosis. […] Our case highlights the importance of whole-body staging, as PET-CT scanning changed the course of care by detecting osseous involvement, necessitating systemic therapy as opposed to local radiation therapy alone.

• #138 SciELO Brazil – Cutaneous primary B-cell lymphomas: from diagnosis to treatment Cutaneous primary B-cell lymphomas: from diagnosis to treatment

  https://www.scielo.br/j/abd/a/TzRvs63f8KYhVmn5kSshytF/

  The study of molecular rearrangements of genes encoding Ig heavy chains (IGH) is useful to differentiate PCBCL from pseudolymphomas. […] More recent studies performed by comparative genomic hybridization (CGH), using microarrays and subsequently confirmed by fluorescence in situ hybridization (FISH) enabled to detect a large number of recurring genetic aberrations in PCLBCL-leg type, and, although less frequently, in PCFCL with predominance of large cells; in contrast, they are rarely found in indolent PCFCL and PCMZL. […] In general, PCBCL have a more indolent clinical course and a more favorable prognosis than their nodal counterparts. […] Overall survival rate in 5 years for PCMZL and PCFCL is higher than 90%. In contrast, for PCLBCL, particularly leg type, prognosis is more guarded, with a survival rate in 5 years lower than 60%. […] Treatment should be selected taking into account the type of lymphoma and its stage, and should be adapted to risk. […] Several therapeutic modalities are available for PCBCL.

• #139 Cutaneous B-Cell Lymphoma – Lymphoma Research Foundation

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/cbcl/

  When extranodal lymphomas originate in the skin (comprising 18 percent of all extranodal lymphomas and five percent of all NHLs) and there is no evidence of disease outside of the skin, they are called primary cutaneous lymphomas. Primary cutaneous B-cell lymphomas (CBCLs) occur when the lymphoma cells originate in B lymphocytes. […] CBCLs are most often indolent (slow-growing). They may appear on the skin as a reddish rash, lump, or nodule and may have a slightly raised and smooth appearance. The disease tends to recur (return after treatment) in new places on the skin, but it rarely develops into a disease that affects other areas of the body. Nearly 50 percent of patients diagnosed with CBCL experience a recurrence after an initial complete response to treatment. Prognosis is usually very good.

• #140 Cutaneous B-Cell Lymphoma – Lymphoma Research Foundation

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/cbcl/

  When extranodal lymphomas originate in the skin (comprising 18 percent of all extranodal lymphomas and five percent of all NHLs) and there is no evidence of disease outside of the skin, they are called primary cutaneous lymphomas. Primary cutaneous B-cell lymphomas (CBCLs) occur when the lymphoma cells originate in B lymphocytes. […] CBCLs are most often indolent (slow-growing). They may appear on the skin as a reddish rash, lump, or nodule and may have a slightly raised and smooth appearance. The disease tends to recur (return after treatment) in new places on the skin, but it rarely develops into a disease that affects other areas of the body. Nearly 50 percent of patients diagnosed with CBCL experience a recurrence after an initial complete response to treatment. Prognosis is usually very good.

• #141 Cutaneous B-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37434388/

  Diagnosis: Diagnosis and disease classification is based on histopathologic 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-adapted therapy: PCFCL and PCMZL patients with solitary or relatively few skin lesions may be effectively 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.

• #142 Diagnosis and Management of Cutaneous B-cell Lymphoma | Plastic Surgery Key

  https://plasticsurgerykey.com/diagnosis-and-management-of-cutaneous-b-cell-lymphoma/

  The diagnosis of primary cutaneous B-cell lymphoma (CBCL) requires that the search for a more widespread lymphoma has been negative. […] A primary cutaneous B-cell lymphoma (CBCL) by definition is one in which the lymphoma involves no other tissue but skin at the time of diagnosis. […] The diagnosis of CBCL requires a 4-mm to 6-mm punch biopsy or incisional or excisional biopsy that includes the reticular dermis and subcutaneous fat. […] The treatment approach may vary widely between observation, local therapy, or systemic therapy depending on the histology and extent and area of skin involvement. Histology of the lesion determines prognosis. […] The diagnosis of a CBCL first requires a biopsy of these mostly papular or tumoral erythematous to violaceous skin lesions. To this end, a 4-mm to 6-mm punch biopsy or excisional or incisional biopsy that includes the reticular dermis and fat should be obtained.

• #143 Cutaneous B-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37434388/

  Diagnosis: Diagnosis and disease classification is based on histopathologic 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-adapted therapy: PCFCL and PCMZL patients with solitary or relatively few skin lesions may be effectively 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.

• #144 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  Without any treatment, PCFCL lesions may be stable, gradually enlarge, or rarely, regress. The histological growth pattern does not influence survival or treatment choice. If PCFCL presents with a solitary lesion or is limited to a single site, treatment involves radiation therapy or surgery. Skin recurrences are common and often are outside the treated site but these do not affect prognosis. […] The recommended therapies for PCMZL are similar to PCFCL. Radiotherapy is highly effective and potentially curative for solitary or few contiguous lesions, but the relapse rates of PCMZL can be higher than PCFCL. […] Localised or solitary leg-type B-cell lymphoma is usually treated with local radiotherapy alone or in conjunction with R-CHOP. Generalised PCDLBCL-LT can be treated with R-CHOP and/or local radiotherapy. […] 5-year survival rates are around 95% for PCFCL. 5-year disease-specific survival of PCMZL is up to 99%. PCDLBCL-LT frequently disseminates to extracutaneous sites and has a poor prognosis in spite of aggressive therapy. 5-year survival rates are approximately 50%.

• #145 Cutaneous B-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37434388/

  Diagnosis: Diagnosis and disease classification is based on histopathologic 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-adapted therapy: PCFCL and PCMZL patients with solitary or relatively few skin lesions may be effectively 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.

• #146 Primary cutaneous B cell lymphoma: Clinical features, diagnosis and treatment

  https://www.wjgnet.com/2218-6190/full/v4/i1/50.htm

  The differentiation of PCMZL from reactive skin changes and other cutaneous lymphomas is important. Morphologic and immunophenotypic features and demonstration of clonality will aid in the differential diagnosis. […] The diagnosis is based on the histological and immunohistochemical examination of biopsy material and ruling out the systemic disease. PCFCL shows nodular or diffuse infiltration of the dermis and subcutaneous tissue; sparing of the epidermis is almost a rule. […] In patients with very extensive skin lesions, systemic rituximab is the first choice of treatment. Rituximab, systemic or intralesional, have been used in limited number of patients with PCFCL in the literature. […] The differential diagnosis especially from PCFCL is important; PCFCL typically comprises centrocytes which don’t express bcl2 or MUM1 in contrast to PCLBCL – LT. […] The diagnosis is difficult because of divergent clinical presentation and absence of lymphadenopathy. Random skin biopsy is beneficial for early diagnosis in ILCL.

• #147 Cutaneous B-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37434388/

  Diagnosis: Diagnosis and disease classification is based on histopathologic 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-adapted therapy: PCFCL and PCMZL patients with solitary or relatively few skin lesions may be effectively 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.

• #148 Cutaneous B-cell lymphoma

  https://dermnetnz.org/topics/cutaneous-b-cell-lymphoma

  Without any treatment, PCFCL lesions may be stable, gradually enlarge, or rarely, regress. The histological growth pattern does not influence survival or treatment choice. If PCFCL presents with a solitary lesion or is limited to a single site, treatment involves radiation therapy or surgery. Skin recurrences are common and often are outside the treated site but these do not affect prognosis. […] The recommended therapies for PCMZL are similar to PCFCL. Radiotherapy is highly effective and potentially curative for solitary or few contiguous lesions, but the relapse rates of PCMZL can be higher than PCFCL. […] Localised or solitary leg-type B-cell lymphoma is usually treated with local radiotherapy alone or in conjunction with R-CHOP. Generalised PCDLBCL-LT can be treated with R-CHOP and/or local radiotherapy. […] 5-year survival rates are around 95% for PCFCL. 5-year disease-specific survival of PCMZL is up to 99%. PCDLBCL-LT frequently disseminates to extracutaneous sites and has a poor prognosis in spite of aggressive therapy. 5-year survival rates are approximately 50%.

• #149 Cutaneous B-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37434388/

  Diagnosis: Diagnosis and disease classification is based on histopathologic 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-adapted therapy: PCFCL and PCMZL patients with solitary or relatively few skin lesions may be effectively 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.

• #150

  https://link.springer.com/article/10.1007/s40257-022-00704-0

  Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. […] Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. […] To date, treatment recommendations for primary cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. […] An accurate pathologic diagnosis of the subtype is the most important first step in the management of pCBCLs. […] To appropriately confirm the diagnosis of pCBCL, systemic involvement must be ruled out. […] Management of pCBCL is complex and requires coordination of a multidisciplinary care team comprising dermatologists, pathologists, hematology-oncologists, and radiation oncologists. […] This review aims to describe the pathophysiological, epidemiological, clinicopathological, immunohistochemical, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management.

• #151 Lymphoma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html

  Patients who have achieved remission need routine surveillance to monitor for complications and relapse, as well as age-appropriate screenings recommended by the U.S. Preventive Services Task Force. […] Current NCCN guidelines outline specific monitoring parameters for follow-up and prevention of secondary disease. […] If a patient is asymptomatic, routine surveillance imaging does not improve outcomes or provide a clinical benefit. […] Surveillance imaging should be used in patients who have reported symptoms or who are at high risk of relapse in a place that would not be easily examined, and who would be candidates for treatment.

• #152 Lymphoma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html

  Patients who have achieved remission need routine surveillance to monitor for complications and relapse, as well as age-appropriate screenings recommended by the U.S. Preventive Services Task Force. […] Current NCCN guidelines outline specific monitoring parameters for follow-up and prevention of secondary disease. […] If a patient is asymptomatic, routine surveillance imaging does not improve outcomes or provide a clinical benefit. […] Surveillance imaging should be used in patients who have reported symptoms or who are at high risk of relapse in a place that would not be easily examined, and who would be candidates for treatment.

• #153 Lymphoma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html

  Patients who have achieved remission need routine surveillance to monitor for complications and relapse, as well as age-appropriate screenings recommended by the U.S. Preventive Services Task Force. […] Current NCCN guidelines outline specific monitoring parameters for follow-up and prevention of secondary disease. […] If a patient is asymptomatic, routine surveillance imaging does not improve outcomes or provide a clinical benefit. […] Surveillance imaging should be used in patients who have reported symptoms or who are at high risk of relapse in a place that would not be easily examined, and who would be candidates for treatment.

• #154 Lymphoma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html

  Patients who have achieved remission need routine surveillance to monitor for complications and relapse, as well as age-appropriate screenings recommended by the U.S. Preventive Services Task Force. […] Current NCCN guidelines outline specific monitoring parameters for follow-up and prevention of secondary disease. […] If a patient is asymptomatic, routine surveillance imaging does not improve outcomes or provide a clinical benefit. […] Surveillance imaging should be used in patients who have reported symptoms or who are at high risk of relapse in a place that would not be easily examined, and who would be candidates for treatment.

• #155 Unveiling Primary Cutaneous B-Cell Lymphomas: New Insights into Diagnosis and Treatment Strategies

  https://www.mdpi.com/2072-6694/17/7/1202

  Comprehensive diagnostic evaluation is essential for effective management. […] While the combination of R-CHOP plus ISRT remains the first-line treatment, novel agents such as lenalidomide and targeted therapies like ibrutinib show promise in relapsed and/or refractory cases. […] Ongoing research into genetic markers and advanced monitoring techniques remains critical for improving disease management and patient outcomes in PCBCL. Key areas for further investigation include understanding the molecular mechanisms of treatment resistance, the interactions between the tumor microenvironment and immune evasion, and the molecular drivers of cutaneous homing and imprinting. Future studies should focus on personalizing treatment regimens based on molecular profiles, optimizing the integration of targeted therapies with existing treatment protocols, and exploring immune-based therapeutic strategies.

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