Contents
B lymphoma is a primary B-cell (small or large lymphocyte) cutaneous lymphoma characterized by tumors and lymphocytic infiltrates in various locations in the skin. The disease accounts for approximately 25% of all primary cutaneous lymphomas and its etiology is unknown. Local irradiation is used in the treatment.
B lymphoma – epidemiology
B lymphoma accounts for approximately 20-25% of primary cutaneous lymphomas. The WHO-EORTC classification distinguishes between benign and malignant lymphomas. In some cases, there is an association with Sjögren’s syndrome, Hashimoto’s thyroiditis, Helicobacter pylori and Borrelia burgdorferi infections.
The origin of type B lymphoma is unknown.
Location of type B lymphoma
Primary cutaneous marginal cutaneous B lymphoma has any location, from the germinal centers it usually affects the head or the trunk, and in 5-10% of cases it is also located outside the skin; multicellular B affects mainly the lower limbs.
Type B lymphoma – symptoms
Type B lymphoma has nodular lesions, usually 1-2 cm above the skin surface, 1 to 5 cm in diameter, pink-red in color, with no signs of decay or only a slight tendency to necrosis and erosions / ulceration.
Diagnostics
Lack of epidermotropism, free space in the papillary layer of the skin, features of B lymphoma consisting of a compact infiltration of small or plasma B lymphocytes in PCMZL, larger lymphocytes sometimes with the reproductive center system in the lymph node in PCFCL and large immunoblasts with high mitotic activity in PCLBC type of lower limbs. No deviation in research.
In addition, the research uses the determination of the characteristics of cancerous B lymphocytes cells forming an infiltrate in the skin:
• in PCMZL – markers of B lymphocytes or plasma cells;
• PCFCL-CD20+, CD79+, Bcl-6+, Bcl-2-, MUM1-;
• PCLBCL, lower limb type – markers of centroblasts or lymphoblasts – CD20 +, CD10-, Bcl-2 +, MUM1-, CD25 / FOXP1 +.
Treatment of lymphoma B
In all types of type B lymphoma, it is used:
• local irradiation with X-rays,
• rituximab intravenously or focally,
• interferon doogniskowo,
• in the form of PCLBCL of the lower limb type, additionally R-CHOP chemotherapy can be used.
What’s the prognosis? Good, in PCFCL skin recurrences 20%, and 5-year survival 95%, in PCLBCL of lower limb type slightly worse prognosis.
Lit.: [1] Grange F., Bekkenk M.W., Wechsler J. i wsp.: Prognostic factors in primary cutaneous large B-cell lymphomas: a European multicenter study. J Clin Oncol 2001, 19; 3602-10. [2] Santucci M., Pimpinelli N., Arganini L.: Primary cutaneous B cell lymphoma: a unique type of low grade lymphoma. Cancer 1991, 67; 3211-26. [3] Li C., Inagaki H., Kuo T.T. i wsp.: Primary cutaneous marginal zone B cell lymphoma: a molecular and clinicopathologic study of 24 Asian cases. Am J Surg Pathol 2003, 27; 1061. [4] Cerroni L., Arzberger E., Putz B. i wsp.: Primary cutaneous follicular center cell lymphoma with follicular growth pattern. Blood 2000, 95; 3922.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House