Overview of cutaneous (skin) lymphoma
Lymphoma is the 6th most common cancer in adult men and women in Australia. Lymphoma can affect people of all ages, however it does increase in incidence in older ages. Lymphoma is the most common cancer in young people aged 15-29 years. Lymphoma is the 3rd most common cancer in children aged 0-14 years. It affects around 6,500 Australians each year.
There are over 80 different types of lymphoma. Lymphoma is the name given to the group of cancers that develop from lymphocytes. Some types of lymphoma are more common and some types are very rare.
Lymphomas are a group of cancers of the lymphatic system. Lymphoma occurs when lymphocytes, which are a type of white blood cell, gain a DNA mutation. The role of lymphocytes is to fight infection, as part of the body’s immune system. There are B-lymphocytes (B-cells) and T-lymphocytes (T-cells) that play different roles.
The lymphoma cells then divide and grow uncontrollably or do not die when they should. Lymphoma has a build-up of abnormal lymphocytes. There are two main types of lymphoma. They are called Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Lymphomas are further divided into:
- Indolent (slow growing) lymphoma
- Aggressive (fast-growing) lymphoma
- B-cell lymphoma are abnormal B-cell lymphocytes & are the most common. B-cell lymphomas account for around 85% of all lymphomas
- T-cell lymphoma are abnormal T-cell lymphocytes. T-cell lymphomas account for around 15% of all lymphomas
Cutaneous T-cell lymphoma (CTCL)
What is it?
Cutaneous (skin) T-cell lymphoma (CTCL) is a rare form of non-Hodgkin lymphoma (NHL). CTCL develops in the skin and has not affected any other areas of the body at the time of diagnosis. Most skin lymphomas are indolent (slow growing) and stay localised (in the same area) to the skin.
Who does it affect?
Cutaneous T-cell lymphomas (CTCL) are more common in men than they are in women. CTCL are more common in older patients but also affect children. The average age of diagnosis is 55 years of age.
Types of CTCL
There are many different subtypes of cutaneous T-cell lymphoma (CTCL). These include:
- Mycosis fungoides (MF) – indolent (slow-growing) T-cell lymphoma
- Sezary syndrome- aggressive (fast-growing) T-cell lymphoma
- Primary cutaneous anaplastic large-cell lymphoma (PCALCL)- indolent (slow-growing) T-cell lymphoma
- Lymphomatoid papulosis (LyP) – indolent T-cell lymphoma
- Subcutaneous panniculitis-like T-cell lymphoma (SPTCL)– indolent T-cell lymphoma
Treatment and prognosis
Early stage CTCL can be brought under good control with the current therapies available today. Most cases are considered incurable. They can be seen as a chronic condition and many patients live otherwise normal lives.
Cutaneous B-cell lymphoma
What is it?
Cutaneous B-cell lymphomas are rare non-Hodgkin lymphomas (NHL) that start in the skin. B-cell lymphomas are skin lymphomas that develop from B cells.
The main symptom is a lump or lumps in the skin and they may look like small pimples. The papules or nodules appear most commonly on the head, neck, back or legs.
Cutaneous lymphomas can be either indolent (slow growing) or aggressive (fast-growing) lymphomas. CBCL accounts for around 20-25 percent of all cutaneous lymphomas.
Types of CBCL
Cutaneous B-cell lymphoma (CBCL) can affect people of all ages. There are three different types of CBCL that include:
- Primary cutaneous follicle centre lymphoma is an indolent (slow-growing) B-cell lymphoma.
- Primary cutaneous marginal zone lymphoma is an indolent (slow-growing) B-cell lymphoma.
- Primary cutaneous diffuse large B-cell lymphoma, leg type is an aggressive (fast-growing) B-cell lymphoma.
Treatment and prognosis
Cutaneous follicle centre lymphoma (slow-growing) and cutaneous marginal zone B-cell lymphoma (slow-growing) both have a good prognosis. They are often diagnosed early, grow slowly, and respond well to treatment. Treatment can involve antibiotics, topical treatments or chemotherapy.
Cutaneous diffuse large B-cell lymphoma behaves as an aggressive (fast-growing) lymphoma. Treatment involves chemotherapy and CBCL responds to treatment but the chance of relapse (come back) is high.
Occasionally, slow-growing B-cell lymphoma can transform into a fast-growing type, although this is rare.
For more information on cutaneous lymphoma