Ciolfi Christian, Tartaglia Jacopo, Sernicola Alvise, Alaibac Mauro
Dermatology Unit, Department of Medicine, University of Padua, Italy.
Dermatol Reports. 2023 Jun 14;16(Suppl 2):9723. doi: 10.4081/dr.2023.9723. eCollection 2024 May 7.
Of all cutaneous lymphomas, 25% are primary cutaneous B-cell lymphomas (PCBCLs). Of these, primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous marginal zone B-cell lymphoma (PCMZL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT) are the most common subtypes. For the diagnosis of PCBCLs, a biopsy combined with immunohistochemistry and histological examination is the gold standard. PCBCLs are categorized into indolent or intermediate to aggressive subtypes based on their clinical behavior in a clinically oriented approach. PCDLBCL-LT has an aggressive course that spreads to extracutaneous sites in about 45% of cases, whereas PCFCL and PCMZL are indolent diseases. As a result, instrumental staging is advised for PCDLBCL-LT but not for extracutaneous disease after a diagnosis of PCMZL or PCFCL. Lastly, dermatoscopy may offer a novel diagnostic tool to improve the clinical recognition of various PCBCL subtypes when used in conjunction with a strong clinical suspicion.
在所有皮肤淋巴瘤中，25% 是原发性皮肤B细胞淋巴瘤（PCBCL）。其中，原发性皮肤滤泡中心淋巴瘤（PCFCL）、原发性皮肤边缘区B细胞淋巴瘤（PCMZL）和原发性皮肤弥漫性大B细胞淋巴瘤，腿部型（PCDLBCL-LT）是最常见的亚型。对于PCBCL的诊断，活检结合免疫组织化学和组织学检查是金标准。基于临床导向的方法，根据其临床行为，PCBCL可分为惰性或中度至侵袭性亚型。PCDLBCL-LT病程侵袭性强，约45%的病例会扩散至皮肤外部位，而PCFCL和PCMZL是惰性疾病。因此，建议对PCDLBCL-LT进行影像学分期，但对于诊断为PCMZL或PCFCL后的皮肤外疾病则不建议。最后，当皮肤镜检查与强烈的临床怀疑相结合时，可能会提供一种新的诊断工具，以提高对各种PCBCL亚型的临床识别。
