Understanding Cutaneous Lymphoma | Types | Risk Factors and Symptoms
Cutaneous lymphomas, also known as lymphomas of the skin, are cancers of the lymphocyte (a type of white blood cell) that are primarily in the skin, but may involve the lymph nodes, blood, and other organs. All cutaneous lymphomas are non-Hodgkin’s lymphoma (NHL).
American Cancer Society estimates that there were approximately 3,500 newly diagnosed cases of cutaneous lymphoma in 2012. While cutaneous lymphomas are rare, accounting for about 5 percent of all NHL, approximately 18,000 people in the United States are estimated to have cutaneous T cell lymphoma.
Classification of cutaneous lymphomas is based on the type of lymphocyte, B cell or T cell, using a combination of microscopic examination and laboratory tests that identify proteins on the lymphoma cells. There are approximately 13 types and subtypes of this disease, which can make classification challenging.
Cutaneous B cell lymphomas (CBCLs) are nearly always slow growing (indolent), with a few exceptions. Prognosis (chance of recovery) from CBCL is usually very good, although many people can experience relapse after initially responding to treatment. CBCLs rarely transform into aggressive, widespread lymphomas. CBCLs can affect any age group and affect men and women equally.
There are four types of CBCL:
Cutaneous T cell lymphoma (CTCL) is one of the most common forms of T cell lymphoma and includes:
Staging is the process of determining the extent (spread) of the disease. Staging is very important because your treatment and the prognosis (chance of recovery) depend on the stage of your cancer. Physical exams, imaging tests (such as a CT scan), biopsies, and blood tests are used to determine stage.
Mycosis fungoides and Sezary syndrome are staged differently than the rest of the cutaneous lymphomas. They are grouped into overall stages of I, II, III, and IV, which may be further subdivided into A and B
A TNM staging system, which is quite complex, is used for the other cutaneous lymphomas, including primary cutaneous follicle-center lymphoma.
Fred Hutch is one of few centers in the United States that has experience treating cutaneous lymphoma and specializes in providing novel therapies and clinical studies for this rare disease. Patients are referred to Fred Hutch for our collaborative efforts between research and clinical studies for peripheral (systemic) and cutaneous T-cell lymphomas in general, as well as specific subtypes, bringing focus to this challenging disease.
The risk factors for cutaneous lymphoma are much the same as the risk factors for non-Hodgkin's lymphoma, including age, gender, and immune deficiency and infections.
Most cases of cutaneous lymphoma have no known cause, so it is difficult to prevent; however, keeping your immune system healthy by avoiding risk factors for HIV/AIDS may lower your risk.
Because this is a skin disease, it is often noticed fairly quickly. Unfortunately, cutaneous lymphomas can frequently resemble other, more common diseases of the skin, such as eczema or psoriasis, often leading to delays in diagnosis especially with early disease.
The symptoms of cutaneous lymphoma depend on the type you have, but may include:
You should see a doctor if you notice a new skin lesion, especially if it is raised, doesn’t go away, or changes in shape or size.
Cutaneous lymphoma can only be diagnosed with tests, including blood tests, imaging tests, and biopsies. A biopsy is a procedure in which a sample of tissue is taken and viewed under a microscope or evaluated using laboratory tests.