Primary cutaneous follicle centre lymphoma Diagnostic Study of Choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
Biopsy is the gold standard test for the diagnosis of primary cutaneous follicle centre lymphoma. Lymph node biopsy is diagnostic of primary cutaneous follicle centre lymphoma. The staging of primary cutaneous follicle centre lymphoma is based on the International Society for Cutaneous Lymphomas (ISCL) / EORTC proposal on TNM classification of cutaneous lymphoma other than mycosis fungoides / sezary syndrome.
Diagnostic Study of Choice
Study of choice
Biopsy is the gold standard test for the diagnosis of primary cutaneous follicle centre lymphoma.
The staging of primary cutaneous follicle centre lymphoma is based on the International Society for Cutaneous Lymphomas (ISCL) / EORTC proposal on TNM classification of cutaneous lymphoma other than mycosis fungoides / sezary syndrome.[1]
Staging
The staging of primary cutaneous follicle centre lymphoma is based on the International Society for Cutaneous Lymphomas (ISCL) / EORTC proposal on TNM classification of cutaneous lymphoma other than mycosis fungoides / sezary syndrome.[1]
| Name | Stage | Description |
|---|---|---|
| T | ||
| T1 | Solitary skin involvement | |
| T1a | A solitary lesion <5 cm diameter | |
| T1 b | A solitary >5 cm diameter | |
| T2 | Regional skin involvement: multiple lesions limited to 1 body region or 2 contiguous body regions | |
| T2a | All-disease-encompassing in a <15-cm-diameter circular area | |
| T2 b | All-disease-encompassing in a >15- and <30-cm-diameter circular area | |
| T2 b | All-disease-encompassing in a >30-cm-diameter circular area | |
| T3 | Generalized skin involvement | |
| T3a | Multiple lesions involving 2 noncontiguous body regions | |
| T3b | Multiple lesions involving ≥3 body regions | |
| N | ||
| N0 | No clinical or pathologic lymph node involvement | |
| N1 | Involvement of 1 peripheral lymph node region that drains an area of current or prior skin involvement | |
| N2 | Involvement of 2 or more peripheral lymph node regions or involvement of any lymph node region† that does not drain an area of current or prior skin involvement | |
| N3 | Involvement of central lymph nodes | |
| M | ||
| M0 | No evidence of extracutaneous non–lymph node disease | |
| M1 | Extracutaneous non–lymph node disease present |
| International Society for Cutaneous Lymphomas (ISCL) / EORTC recommendations for staging evaluation in cutaneous lymphomas other than mycosis fungoides / sezary syndrome[1]
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| Complete history/review of systems and physical examination |
| Laboratory studies |
| Complete blood count, comprehensive serum chemistries, serum LDH |
| Whenever indicated, relevant flow cytometric studies of peripheral blood mononuclear cells |
| Imaging studies |
| CT of chest, abdomen and pelvis with contrast alone or with whole-body PET (18F-FDG); include CT or ultrasound of neck if clinically indicated |
| Whole-body integrated PET/CT (as alternative imaging study to the standard contrast-enhanced CT) |
| Bone marrow biopsy and aspirate |
| Required in cutaneous lymphomas with intermediate to aggressive clinical behavior as categorized in the WHO-EORTC classification |
| Should be considered in cutaneous lymphomas with indolent clinical behavior, but not required unless indicated by other staging assessments |
| Additional studies as indicated clinically |
References
- ↑ 1.0 1.1 1.2 1.3 Kim, Y. H.; Willemze, R.; Pimpinelli, N.; Whittaker, S.; Olsen, E. A.; Ranki, A.; Dummer, R.; Hoppe, R. T. (2007). "TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer (EORTC)". Blood. 110 (2): 479–484. doi:10.1182/blood-2006-10-054601. ISSN 0006-4971.