Subcutaneous Lymphoma

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This entry looks at subcutaneous lymphoma, one of those subtypes of lymphoma. 'Lymphoma' is an umbrella term that loosely refers to several dozen independent categorical types and subtypes of cancers of the lymphatic system. However, as a term, subcutaneous lymphoma is simply a shortened version of subcutaneous panniculitis-like T cell lymphoma or SPTCL.

This subcutaneous lymphoma is considered an extra-nodal lymphoma. It is extremely rare, representing about one percent of all skin-associated T cell lymphomas. All T cell lymphomas put together only represent 15% of ALL lymphomas, and there are fewer cutaneous lymphomas than peripheral ones. I don't have a reliable number handy, but the annual number of diagnoses of this rare subtype surely does not even come close to four figures.

Subcutaneous lymphoma has only recently been classified as its own entity, meaning that there is precious little reliable data on it. The 5 year relative survival rate is rather high at 82%, likely because this is a disease with an indolent clinical course—it grows very slowly. That said, there is a variant of the disease that is extremely aggressive, and this variant can be identified through molecular analysis.

Symptoms of Subcutaneous Lymphoma

Symptoms of subcutaneous panniculitis-like T cell lymphoma include so-called nodules, plaques or ulcers developing just under the skin. Diagnosis is not easy because its early symptoms are known to be mistaken for skin conditions that are more common, such as eczema, dermatitis, psoriasis and cellulitis. In certain cases, patients may develop more common lymphoma-like symptoms, such as weight loss, fevers and chills.

Treatment for Subcutaneous Lymphoma

Treatment in the past for subcutaneous lymphoma has been with combination chemotherapy that included doxorubicin (i.e. CHOP) along with radiation. However, emerging research suggests that corticosteroids may be just as effective at managing the disease without doing the damage that chemotherapy and radiation can often do.

Sources

MedScape Subcutaneous Panniculitis-like T-cell Lymphoma

Bagheri F et al. An illustrative case of subcutaneous panniculitis-like T-cell lymphoma. J Skin Cancer. 2011;2011:824528.

Hogue SR et al. Subcutaneous panniculitis-like T-cell lymphoma: a clinicopathological, immunophenotypic and molecular analysis of six patients. Br J Dermatol. 2003 Mar;148(3):516-25.

Clinical Options, Relative Frequency and Disease-Specific 5-Year Survival Rates of Patients With Primary CTCL.

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