Primary cutaneous follicle centre lymphoma staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

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]

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]

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. 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.


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