Ingen-Housz-Oro Saskia, Bagot Martine
Service de dermatologie, CHU Henri-Mondor, AP-HP, 94000 Créteil, France.
Rev Prat. 2009 Nov 20;59(9):1207-15.
Cutaneous lymphomas are lymphoproliferations affecting skin only at the time of diagnosis. There are two major types, B-cell lymphomas and T-cell lymphomas, which prognosis depends of histological subtype and staging evaluation. In cutaneous B-cell lymphomas, there are two indolent subtypes (primary cutaneous marginal zone B-cell lymphoma and primary cutaneous follicle center lymphoma) and one more aggressive type (primary cutaneous diffuse large B-cell lymphoma, leg type). Classification of T-cell lymphomas distinguishes indolent subtypes such as mycosis fungoides, the most frequent of T-cell lymphomas, and CD30+ lymphoproliferations such as lymphomatoid papulosis, whereas other T-cell lymphoma subtypes have a more pejorative prognosis such as Sezary syndrome (erythrodermic and leukemic form of mycosis fungoides) and CD30- lymphomas. Staging evaluation with CT-scan of chest, abdomen and pelvis, bone marrow examination if necessary and lymph node biopsy if palpable node over 1 or 1.5 cm diameter, is necessary for therapeutic decision.
皮肤淋巴瘤是在诊断时仅累及皮肤的淋巴细胞增殖性疾病。主要有两种类型，即B细胞淋巴瘤和T细胞淋巴瘤，其预后取决于组织学亚型和分期评估。在皮肤B细胞淋巴瘤中，有两种惰性亚型（原发性皮肤边缘区B细胞淋巴瘤和原发性皮肤滤泡中心淋巴瘤）和一种侵袭性更强的类型（原发性皮肤弥漫性大B细胞淋巴瘤，腿部型）。T细胞淋巴瘤的分类区分了惰性亚型，如蕈样肉芽肿（最常见的T细胞淋巴瘤）和CD30+淋巴细胞增殖性疾病，如淋巴瘤样丘疹病，而其他T细胞淋巴瘤亚型预后更差，如塞扎里综合征（蕈样肉芽肿的红皮病和白血病形式）和CD30-淋巴瘤。胸部、腹部和骨盆的CT扫描进行分期评估，必要时进行骨髓检查，直径超过1或1.5厘米的可触及淋巴结进行淋巴结活检，对于治疗决策是必要的。
