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Cutaneous lymphomas, also known as lymphomas of the skin, are cancers of lymphocytes (a type of white blood cell) that start in the skin and may involve the lymph nodes, blood and other organs. Because these cancers can look like more common skin diseases, diagnosis often takes time and usually requires expert review and specialized tests.
Cutaneous Lymphoma Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.
Why Cutaneous Lymphoma Can Be Hard to Diagnose
Cutaneous lymphoma is often noticed fairly quickly because it affects the skin, but it can closely resemble conditions such as eczema or psoriasis. This similarity often leads to delays in diagnosis, especially in early disease. A long‑lasting or changing rash that does not improve with usual treatments should prompt further evaluation.
There is no routine screening test for cutaneous lymphoma like there are for some other cancers.
When to See a Physician
You should see a physician if you notice a new skin lesion, especially if it is raised, does not go away or changes in shape or size. A rash that keeps coming back in the same place, looks different from your past skin problems or does not respond to standard creams or medicines may also need a closer look.
If your symptoms are not improving, your primary care provider may refer you to a dermatologist or cutaneous lymphoma specialist for further evaluation.
Tests to Diagnose Cutaneous Lymphoma
Cutaneous lymphoma is diagnosed using a combination of tests. A skin biopsy is the primary test used to confirm the diagnosis. Blood tests, imaging tests and other procedures may help determine the type of cutaneous lymphoma and whether it has spread. Your care team may use several of the following:
- Physical exam and medical history: Your physician examines your skin, lymph nodes and overall health and asks about how long you have had symptoms, how they have changed and what treatments you have already tried.
- Skin biopsy: A biopsy is a procedure in which a sample of tissue is taken from the skin and viewed under a microscope or evaluated using laboratory tests. Pathologists use microscopic examination and specialized tests to identify proteins on lymphoma cells and determine the type of cutaneous lymphoma.
- Lymph node biopsy: If lymph nodes are enlarged or suspicious, a sample may be removed and examined to see whether lymphoma is present.
- Blood tests: Blood tests may look for abnormal lymphocytes, signs of lymphoma in the blood and information about how your organs are working before and during treatment.
- Imaging tests: Imaging tests, such as CT scans, may be used to see whether the lymphoma has spread to lymph nodes or internal organs. These tests are also part of the staging process, which helps guide treatment and prognosis.
- Bone marrow tests: In some cases, a bone marrow aspiration and biopsy may be performed to check whether lymphoma has spread to the bone marrow.
- Flow cytometry and molecular testing: Specialized laboratory tests may be performed on blood, skin, lymph node or bone marrow samples to identify specific markers on lymphoma cells and help classify the disease.
Fred Hutch Expertise in Cutaneous Lymphoma Diagnosis
At Fred Hutch, diagnosis and staging are done by a team that includes hematologist‑oncologists, dermatologists, pathologists and radiation oncologists who specialize in cutaneous lymphoma. The Cutaneous Lymphoma Specialty Clinic brings these experts together to comprehensively evaluate your disease and coordinate the tests you need. Your care team will explain what your test results mean, discuss your type and stage of cutaneous lymphoma and help you understand your treatment options and follow‑up plan.