Cutaneous Lymphomas
Cutaneous lymphomas are a type of non-Hodgkin lymphoma (cancer of the lymphatic system) that primarily affects the skin. These cancers originate from lymphocytes, a type of white blood cell, and manifest in the skin, though they can sometimes involve other organs. Cutaneous lymphomas are classified into two main types based on the type of lymphocyte involved: T-cell and B-cell cutaneous lymphomas.
Types of Cutaneous Lymphomas
- Cutaneous T-Cell Lymphomas (CTCL):
- These are the most common form of cutaneous lymphomas. They develop from T-cells, which are part of the immune system.
- Mycosis Fungoides:
- The most common form of CTCL. It usually presents as patches of scaly, red skin that resemble eczema or psoriasis. Over time, it can progress to form plaques and tumors.
- It often affects areas like the chest, back, or buttocks, and can be slow-growing.
- Sézary Syndrome:
- A more aggressive form of CTCL, where cancerous T-cells are found in the blood in addition to the skin.
- It often causes widespread skin redness, scaling, and severe itching, along with enlarged lymph nodes.
- Cutaneous B-Cell Lymphomas (CBCL):
- Less common than CTCL, these develop from B-cells, another type of lymphocyte.
- Primary Cutaneous Follicle Center Lymphoma:
- Presents as nodules or plaques, often on the head, neck, or upper body. This form tends to have a favorable prognosis.
- Primary Cutaneous Marginal Zone B-Cell Lymphoma:
- Usually appears as small, painless lumps or nodules on the arms or trunk.
- Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type:
- A more aggressive form of CBCL, typically presenting as large, rapidly growing tumors, often on the legs.
Symptoms of Cutaneous Lymphomas:
- Red, scaly patches or plaques on the skin
- Raised lumps or tumors
- Itching (pruritus)
- Eczema-like rashes or psoriasis-like plaques
- In advanced cases, ulceration or infection of lesions
- Enlarged lymph nodes (in more aggressive forms like Sézary syndrome)
Causes:
- The exact cause of cutaneous lymphomas is unclear, but they are believed to result from genetic mutations in lymphocytes.
- Environmental triggers, immune system dysfunction, and viral infections (e.g., HTLV-1) may play a role in some cases.
Diagnosis:
- Skin biopsy to examine cells under a microscope
- Blood tests to look for abnormal lymphocytes (especially in Sézary syndrome)
- Imaging to assess lymph node involvement
- Flow cytometry or other advanced tests to determine the type of lymphoma
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