Quereux Gaëlle, Frot Anne Sophie, Brocard Anabelle, Leux Cécile, Renaut Jean-Jacques, Dreno Brigitte
Dermatology Department, Nantes University Hospital Center, Place Alexis Ricordeau, 44093 Nantes, France.
Eur J Dermatol. 2009 May-Jun;19(3):216-20. doi: 10.1684/ejd.2009.0633. Epub 2009 Feb 27.
Primary cutaneous B-cell lymphomas are a rare entity. They are included in the distinct classification of primary cutaneous lymphomas, the WHO-EORTC. In order to be confirmed, the primary nature of a cutaneous lymphoma requires that negative results of a CT scan of the chest, abdomen and pelvis and of a bone marrow biopsy (BMB) be obtained. Nevertheless, there is a question as to whether BMB should be performed routinely in view of the good prognosis of certain cutaneous B-cell lymphomas and the invasive nature of the examination. To answer that question, we studied retrospectively 62 cases of cutaneous B-cell lymphomas in which a BMB was performed. In 4 cases, lymph nodes, and in one case pancytopenia were identified during the initial evaluation performed at the same time as BMB and thus these patients were excluded from the analysis. Among the 57 patients, the BMB was positive in only 3 patients (5.2%). Interestingly, the positivity of the biopsy did not significantly affect the way that the treatment was given. In conclusion, this study demonstrates that it is not indispensable to perform a routine BMB for a Primary cutaneous B-cell lymphoma with cutaneous lesions on examination and with negative CT Scan and blood laboratory evaluations.
原发性皮肤B细胞淋巴瘤是一种罕见的疾病。它们被纳入原发性皮肤淋巴瘤的独特分类，即世界卫生组织-欧洲肿瘤研究与治疗组织（WHO-EORTC）分类。为了确诊，皮肤淋巴瘤的原发性需要获得胸部、腹部和骨盆的CT扫描以及骨髓活检（BMB）的阴性结果。然而，鉴于某些皮肤B细胞淋巴瘤的良好预后以及该检查的侵入性，对于是否应常规进行BMB存在疑问。为了回答这个问题，我们回顾性研究了62例进行了BMB的皮肤B细胞淋巴瘤病例。在4例中，在与BMB同时进行的初始评估中发现了淋巴结，在1例中发现了全血细胞减少，因此这些患者被排除在分析之外。在这57例患者中，只有3例（5.2%）BMB呈阳性。有趣的是，活检的阳性结果对治疗方式没有显著影响。总之，本研究表明，对于检查时有皮肤病变、CT扫描和血液实验室评估均为阴性的原发性皮肤B细胞淋巴瘤，常规进行BMB并非必不可少。
