Cutaneous T-cell lymphoma - Lymphoma Association

More documents

Recommendations

Info

When you are examined the doctor will feel your neck, under your arms and inyour groin area to detect any enlarged lymph nodes. You won’t need any internalexaminations. The blood tests will include blood cell counts and measurements of thelevels of some chemical substances that are found in the blood, including a chemicalcalled lactate dehydrogenase (LDH).The choice of which further tests you will have will depend on exactly which type oflymphoma the early tests show you have and on your general health. If you have themost common skin lymphoma, mycosis fungoides, and your physical examination andblood tests are normal the only other test you will have is a chest X-ray (and perhaps anultrasound examination).Scans are not done as commonly as they are in people with other non-Hodgkinlymphomas. They might be done if other investigations suggest there are lymphomacells in the blood or lymph nodes. The most common scan is computed tomography(CT) of the chest, abdomen and pelvis. Another scan called ‘positron-emissiontomography’ (PET), which is often combined with CT into a PET/CT scan, is done veryoccasionally. These scans show up your internal organs in great detail and can takeanything from 30 minutes to 2 hours to do. They are usually done as an outpatient,but they might have to be done at a larger medical centre than your local hospital. Youwould be given detailed instructions on all aspects of where to go and on preparing forand having these tests.A few people with suspected skin lymphoma will have a bone marrow biopsy,although this is more usual in people with cutaneous B-cell lymphomas. In this testa small sample of bone marrow is taken from your hip bone using a needle. The skinover the bone is numbed first using a local anaesthetic and you will be given painkillersto help with any discomfort afterwards. The sample will be examined under themicroscope to see if it contains any lymphoma cells.If enlarged lymph nodes are found when you are examined or if they are seen on thescans, a node might be removed so that it can be examined under the microscope – alymph node biopsy (sometimes called an ‘excision biopsy’). The node is removed in ashort operation under local anaesthetic or sometimes under general anaesthetic.All these tests are done to find out which parts of your body the lymphoma is affecting.They are also done to make sure that the lymphoma has definitely started in the skinitself and that it hasn't spread there from somewhere else. This is important becauselymphomas that start elsewhere, for example in the internal lymph nodes, behave quitedifferently and require different treatment. Once all the results are back, the medicalteam can decide on the best course of treatment for you.If you would like to talk to someone about your tests or would like moreinformation on blood tests, scans or bone marrow biopsy, please ring our helpline(0808 808 5555). Alternatively the information can be downloaded from ourwebsite (www.lymphomas.org.uk).Cutaneous T-cell lymphomaLYM0157/CTCL/2013v36/18
What do the tests tell the medical team?The appearance of your skin, together with the physical examination and all the testresults will usually provide:● a diagnosis of what type of skin lymphoma you have – whether it is a T-cell or aB-cell skin lymphoma, for example, and exactly which one● information on how the lymphoma is behaving – whether it is slow growing(low grade or 'indolent') or faster growing (high grade)● an indication of how much the lymphoma is affecting the body – the ‘stage’ of thelymphoma.It is important to know the type, grade and stage of a lymphoma so that the doctorswill have an idea of how it might behave in future and of how best to treat you.What do ‘low grade’ and ‘high grade’ mean?The skin biopsy will help the specialist to know how fast the lymphocytes are dividingand multiplying. Slow-growing lymphomas are described as ‘low grade’ and fastergrowing lymphomas as ‘high grade’. Most skin lymphomas are slow growing. Thetable below divides the different types of CTCL into those that are slow growing andthose that develop and grow more rapidly. How fast the lymphoma is developing willbe an important factor in deciding which treatments would be most suitable and howsoon the treatment should be started.Slow-growing types of CTCL● Classic mycosis fungoides● Rarer types of mycosis fungoides:– folliculotropic mycosis fungoides– pagetoid reticulosis– granulomatous slack skin● Primary cutaneous CD30-positivelymphoproliferative disorders:●– primary cutaneous anaplasticlarge-cell lymphoma– lymphomatoid papulosisSubcutaneous panniculitis-like T-celllymphoma● Primary cutaneous CD4-positivesmall/medium T-cell lymphomaFaster growing types of CTCL● Sézary syndrome● Adult T-cell leukaemia/lymphoma● Extranodal NK/T-cell lymphoma, nasaltype● Primary cutaneous peripheral T-celllymphoma, unspecified● Primary cutaneous CD8-positiveaggressive epidermitropic cytotoxicT-cell lymphoma● Primary cutaneous gamma/delta T-celllymphomaYou will find information about the different types of CTCL on pages 10–14.Cutaneous T-cell lymphomaLYM0157/CTCL/2013v37/18
Page 1 and 2: Freephone helpline 0808 808 5555inf
Page 3: What causes skin lymphoma?The cause
Page 8 and 9: What do the ‘stages’ mean?The s
Page 10 and 11: Some slow-growing lymphomas do not
Page 12 and 13: Erythroderma can be treated by extr
Page 14 and 15: people, the average age being about
Page 16 and 17: AcknowledgementsWe are very gratefu
Page 18: Willemze R, et al. WHO-EORTC classi

Cutaneous T-cell lymphoma - Lymphoma Association

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?