Role of imaging in low grade cutaneous B-cell lymphoma presenting in the skin

Publication date: Available online 29 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): M.K. Kheterpal, J. Dai, S. Geller, M. Pulitzer, Andy Ni, P.L. Myskowski, A. Moskowitz, J. Kim, E.K. Hong, S. Fong, R.T. Hoppe, Y.H. Kim, S.M. Horwitz

Abstract

Background

Whole body imaging is current standard of care for staging all patients presenting with skin lesion(s) of B-cell lymphomas (BCL), regardless of skin disease extent, however supporting data are lacking.

Objective

To determine the clinical utility of imaging in detection of systemic involvement in low grade cutaneous B-cell lymphoma presenting in the skin.

Methods

Retrospective cohort analysis of patients presenting with cutaneous lesions of BCLs at Memorial Sloan Kettering Cancer Center (MSKCC) and Stanford University (SU) from 1997-2016.

Results

At initial staging, of the 522 patients (306 marginal zone and 216 follicle-center cell histology), extracutaneous disease was noted in 3.6% and 8.8% of patients with MZL and FCL histology respectively. In patients with systemic involvement, imaging alone identified 81.8% (9/11) of MZL and 89.4% of follicular lymphoma (FL) cases. In primary cutaneous MZL (pc-MZL) and primary cutaneous follicle center lymphoma (pc-FCL), 1.7% and 3.0% subsequently developed extracutaneous involvement (median follow-up of 45 and 47 months respectively).

Limitations

Retrospective nature of this study.

Conclusions

Imaging is effective in identifying the patients with systemic involvement in indolent BCLs presenting in the skin, however incidence is low. After negative initial staging, pc-MZL patients may be followed clinically without routine imaging.

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