Clinician’s perspective on the diagnosis of primary cutaneous B-cell lymphoma
https://doi.org/10.4081/dr.2023.9723
Accepted: 27 May 2023
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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. PCBCLs are categorized into indolent or intermediate to aggressive subtypes based on their clinical behavior in a clinically oriented approach. 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.
Bradford PT, Devesa SS, Anderson WF, Toro JR. Cutaneous lymphoma incidence patterns in the United States: a population-based study of 3884 cases. Blood 2009;113:5064-73.
Willemze R, Cerroni L, Kempf W, et al. The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood 2019;133:1703-14.
Dumont M, Battistella M, Ram-Wolff C, et al. Diagnosis and treatment of primary cutaneous B-cell lymphomas: state of the art and perspectives. Cancers 2020;12:1497.
Russo I, Fagotto L, Sernicola A, Alaibac M. Primary cutaneous B-cell lymphomas in patients with impaired immunity. Front Oncol 2020;10:1296.
Breakell T, Waibel H, Schliep S, et al. Intravascular large B-cell lymphoma: a review with a focus on the prognostic value of skin involvement. Curr Oncol 2022;29:2909-19.
Skala SL, Hristov B, Hristov AC. Primary cutaneous follicle center lymphoma. Arch Pathol Lab Med 2018;142:1313-21.
Franco R, Fernández-Vázquez A, Mollejo M, et al. Cutaneous presentation of follicular lymphomas. Mod Pathol Off J U S Can Acad Pathol Inc 2001;14:913-9.
Suárez AL, Pulitzer M, Horwitz S, et al. Primary cutaneous B-cell lymphomas. J Am Acad Dermatol 2013;69:329.e1-329.e13.
Kluk J, Charles-Holmes R, Carr RA. Primary cutaneous follicle centre cell lymphoma of the scalp presenting with scarring alopecia: correspondence. Br J Dermatol 2011;165:205-7.
Barzilai A, Feuerman H, Quaglino P, et al. Cutaneous B-cell neoplasms mimicking granulomatous rosacea or rhinophyma. Arch Dermatol 2012;148. Available from: http://archderm.jamanetwork.com/article.aspx?doi=10.1001/archdermatol.2011.3575 [cited 2023 Mar 29]
Massone C, Fink-Puches R, Laimer M, Rütten A, et al. Miliary and agminated-type primary cutaneous follicle center lymphoma: report of 18 cases. J Am Acad Dermatol 2011;65:749-55.
Berti E, Alessi E, Caputo R, et al. Reticulohistiocytoma of the dorsum. J Am Acad Dermatol 1988;19:259-72.
Weltgesundheitsorganisation. WHO classification of tumours of haematopoietic and lymphoid tissues. Revised 4th edition. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., (eds.). Lyon: International Agency for Research on Cancer; 2017:585.
Gerami P, Wickless SC, Querfeld C, et al. Cutaneous involvement with marginal zone lymphoma. J Am Acad Dermatol 2010;63:142-5.
Servitje O, Muniesa C, Benavente Y, et al. Primary cutaneous marginal zone B-cell lymphoma: Response to treatment and disease-free survival in a series of 137 patients. J Am Acad Dermatol 2013;69:357-65.
Hoefnagel JJ, Vermeer MH, Jansen PM, et al. Primary cutaneous marginal zone B-cell lymphoma: clinical and therapeutic features in 50 cases. Arch Dermatol 2005;141:1139-45.
Dangien A, Beylot-Barry M, Battistella M, et al. Clinical presentation, therapeutic approach and outcome of primary cutaneous marginal zone B-cell lymphoma presenting as AL amyloidoma of the skin. Br J Dermatol 2019;181:607-9.
Cerroni L, Zöchling N, Pütz B, Kerl H. Infection by Borrelia burgdorferi and cutaneous B-cell lymphoma. J Cutan Pathol 1997;24:457-61.
Tadiotto Cicogna G, Ferranti M, Alaibac M. Diagnostic workup of primary cutaneous B cell lymphomas: a clinician’s approach. Front Oncol 2020;10:988.
Ponzoni M, Ferreri AJM, Mappa S, et al. Prevalence of Borrelia Burgdorferi infection in a series of 98 primary cutaneous lymphomas. The Oncologist 2011;16:1582-8.
Dojcinov SD, Venkataraman G, Raffeld M, et al. EBV positive mucocutaneous ulcer--a study of 26 cases associated with various sources of immunosuppression. Am J Surg Pathol 2010;34:405-17.
Hart M, Thakral B, Yohe S, et al. EBV-positive mucocutaneous ulcer in organ transplant recipients: a localized indolent posttransplant lymphoproliferative disorder. Am J Surg Pathol 2014;38:1522-9.
Grange F, Joly P, Barbe C, et al. Improvement of survival in patients with primary cutaneous diffuse large B-cell lymphoma, leg type, in France. JAMA Dermatol 2014;150:535-41.
Geller S, Marghoob AA, Scope A, et al. Dermoscopy and the diagnosis of primary cutaneous B-cell lymphoma. J Eur Acad Dermatol Venereol 2018;32:53-6.
Errichetti E, Geller S, Zalaudek I, et al. Dermatoscopy of nodular/plaque-type primary cutaneous T- and B-cell lymphomas: a retrospective comparative study with pseudolymphomas and tumoral/inflammatory mimickers by the International Dermoscopy Society. J Am Acad Dermatol 2022;86:774-81.
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
