Primary cutaneous follicle centre lymphoma staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

The staging of primary cutaneous follicle centre lymphoma is based on the International Society for Cutaneous Lymphomas (ISCL) / EORTC proposal on TNM classification of cutaneous lymphoma other than mycosis fungoides / sezary syndrome.^[1]

Staging

The staging of primary cutaneous follicle centre lymphoma is based on the International Society for Cutaneous Lymphomas (ISCL) / EORTC proposal on TNM classification of cutaneous lymphoma other than mycosis fungoides / sezary syndrome.^[1]

**International Society for Cutaneous Lymphomas (ISCL) / EORTC proposal on TNM classification of cutaneous lymphoma other than mycosis fungoides / sezary syndrome^[1]**
Name	Stage	Description
T
	T1	Solitary skin involvement
	T1a	A solitary lesion <5 cm diameter
	T1 b	A solitary >5 cm diameter
	T2	Regional skin involvement: multiple lesions limited to 1 body region or 2 contiguous body regions
	T2a	All-disease-encompassing in a <15-cm-diameter circular area
	T2 b	All-disease-encompassing in a >15- and <30-cm-diameter circular area
	T2 b	All-disease-encompassing in a >30-cm-diameter circular area
	T3	Generalized skin involvement
	T3a	Multiple lesions involving 2 noncontiguous body regions
	T3b	Multiple lesions involving ≥3 body regions
N
	N0	No clinical or pathologic lymph node involvement
	N1	Involvement of 1 peripheral lymph node region that drains an area of current or prior skin involvement
	N2	Involvement of 2 or more peripheral lymph node regions or involvement of any lymph node region† that does not drain an area of current or prior skin involvement
	N3	Involvement of central lymph nodes
M
	M0	No evidence of extracutaneous non–lymph node disease
	M1	Extracutaneous non–lymph node disease present

International Society for Cutaneous Lymphomas (ISCL) / EORTC recommendations for staging evaluation in cutaneous lymphomas other than mycosis fungoides / sezary syndrome^[1]
Complete history/review of systems and physical examination
Laboratory studies
Complete blood count, comprehensive serum chemistries, serum LDH
Whenever indicated, relevant flow cytometric studies of peripheral blood mononuclear cells
Imaging studies
CT of chest, abdomen and pelvis with contrast alone or with whole-body PET (18F-FDG); include CT or ultrasound of neck if clinically indicated
Whole-body integrated PET/CT (as alternative imaging study to the standard contrast-enhanced CT)
Bone marrow biopsy and aspirate
Required in cutaneous lymphomas with intermediate to aggressive clinical behavior as categorized in the WHO-EORTC classification
Should be considered in cutaneous lymphomas with indolent clinical behavior, but not required unless indicated by other staging assessments
Additional studies as indicated clinically

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Kim, Y. H.; Willemze, R.; Pimpinelli, N.; Whittaker, S.; Olsen, E. A.; Ranki, A.; Dummer, R.; Hoppe, R. T. (2007). “TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer (EORTC)”. Blood. 110 (2): 479–484. doi:10.1182/blood-2006-10-054601. ISSN 0006-4971.

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[KimWillemze2007-1] 1.0 ^1.1 ^1.2 ^1.3 Kim, Y. H.; Willemze, R.; Pimpinelli, N.; Whittaker, S.; Olsen, E. A.; Ranki, A.; Dummer, R.; Hoppe, R. T. (2007). “TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer (EORTC)”. Blood. 110 (2): 479–484. doi:10.1182/blood-2006-10-054601. ISSN 0006-4971.

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