Diagnosing and Treating Cutaneous B Cell Lymphoma

Cutaneous B cell lymphoma is a type of lymphoma (cancer) that begins in the skin and affects the B cells of the lymphatic system. While most subtypes of lymphoma are found in the nodal system (i.e. somewhere among the body's lymph nodes), there are a few lymphomas that are extranodal, that begin outside of that system. Cutaneous B cell lymphoma is one of these extranodal lymphomas.

The most commonly diagnosed cutaneous B cell lymphoma is primary cutaneous follicle center lymphoma, followed by primary cutaneous marginal zone B cell lymphoma and finally by primary cutaneous diffuse large B cell lymphoma.

Diagnosing Cutaneous B Cell Lymphoma

In order to diagnose a cutaneous B cell lymphoma, a biopsy must be taken and examined by a qualified pathologist. A doctor will also do a complete exam of the skin and the lymph nodes, followed by lab tests including a complete blood count. Though involvement of other parts of the body is rare, certain imaging tests are necessary to make a complete diagnosis, including PET/CT scans of the chest and abdomen. Finally, some situations call for a bone marrow biopsy.

Treating Cutaneous B Cell Lymphoma

Most subtypes of cutaneous B cell lymphoma are highly treatable, especially if the disease is found to be a primary cutaneous lymphoma (meaning it originates in the skin; if the disease is found to be systemic, it will have a different treatment regimen and different prognosis). Most subtypes of this disease are extremely indolent—so slow-growing that they present no immediate threat to the patient, and in some cases will require no treatment at all. When treatment is necessary, it can range from topical ointments to radiotherapy to, in the more drastic scenarios, combination chemotherapy regimens.

While relapse or recurrence in cutaneous B cell lymphoma is extremely common—as many as two-thirds of patients experience a recurrence—readers should understand nonetheless that in most cases of cutaneous B cell lymphoma, the prognosis is extremely good, and that the 5-year survival rate (also known as the cure rate) is somewhere between 89% and 96%.

Sources

Cutaneous Lymphoma Foundation, Fast Facts: Primary Cutaneous B-cell Lymphoma

Demierre M et al. Primary cutaneous b-cell lymphomas: a practical approach. Hematol Oncol Clin N Am, 17(2003) 1333-1350.

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