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cutaneous B-cell lymphoma
Etiology:
1) may be primary (i.e. confined to the skin)
2) may be associated with systemic B-cell lymphoma
Epidemiology:
1) age:> 50 years
2) male:female ratio 27:1
3) rare
Pathology:
1) dense nodular or diffuse monomorphous infiltrate of lymphocytes generally separated from the epidermis by a zone of normal collagen
2) immunophenotyping: CD19, CD20, CD22, CD28
3) immunoglobulin gene rearrangement
Clinical manifestations:
1) indurated plaques or nodules with a smooth surface
2) generally single or multiple lesions, localized in distribution; if widespread, asymmetric distribution
3) generally asymptomatic
4) different shades of red to plum in color
5) lesions firm, nontender, cutaneous of fixed subcutaneous masses
6) lymphadenopathy with systemic B-cell lymphoma
Laboratory:
1) complete blood count (CBC)
2) skin biopsy
3) lymph node biopsy (if indicated)
4) bone marrow biopsy
Differential diagnosis:
1) cutaneous T-cell lymphoma (mycosis fungoides)
2) leukemia cutis
3) leprosy
4) granuloma faciale
5) atypical mycobacterial infection
6) sarcoidosis
Management:
1) radiation therapy for localized disease
2) chemotherapy for systemic disease (see B-cell lymphoma)
Related
granuloma faciale; eosinophilic granuloma of skin
leukemia cutis
mycosis fungoides/Sezary syndrome
sarcoidosis
General
cutaneous lymphoma
B-cell lymphoid neoplasm (B-cell lymphoma)
References
- Color Atlas & Synopsis of Clinical Dermatology, Common
& Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY,
1997, pg 552
- Senff NJ et al,
Reclassification of 300 primary cutaneous B-cell lymphomas
according to the new WHO-EORTC classification for cutaneous
lymphomas: Comparison with previous classifications and
identification of prognostic markers.
J Clin Oncol 2007, 25:1581
PMID: 17353548