What Is Cutaneous B-Cell Lymphoma?

Cutaneous B-cell lymphoma (CBCL) is a unique group of lymphomas that are hyperplastic with B-lymphocytes in cutaneous lymphomas. Skin lesions are common in the head, neck, trunk, and lower limbs. The lesions can be single, multiple, or general red or purplish pimples, nodules, or plaques that last for months or years. CBCL can be divided into two categories: primary cutaneous B-cell lymphoma and secondary cutaneous B-cell lymphoma. Primary CBCL can be cured by local radiotherapy or excision, and the prognosis is good.

Basic Information

Visiting department

Dermatology

Common locations

Head, neck, torso and lower limbs

Common causes

Etiology unknown

Common symptoms

Giant nodules or plaques

Causes of cutaneous B-cell lymphoma

The cause is unknown. In the past, CBCL was classified as reticulosarcoma or reticulocytosis due to the lack of enzymatic cytochemistry, immunology, and electron microscopy. In recent years, the development of immunology believes that the disease is a type of cutaneous lymphoma.

Clinical manifestations of cutaneous B-cell lymphoma

1. Skin lesions are common in the head, neck, torso, and lower limbs, and mucous membranes can also be affected. The skin damage of CBCL is mostly secondary (67.5%), but it can also be primary (33.5%).
2. Different clinical manifestations. Damage can be single, multiple, or widespread. It is usually a large nodule or plaque, ranging in color from red, blue, purple, or brown, and sometimes forms an ulcer; red maculopapular rash is also seen; occasional subcutaneous masses are seen. Compared with T-cell lymphoma, CBCL usually has no scaly skin lesions or erythroderma.

Skin B-cell lymphoma examination

1. Lab tests reduce hemoglobin; white blood cell count decreases. It is worth noting that white blood cells may not be reduced in early patients, but most of them have reduced hemoglobin, which has certain implications for diagnosis. Protein electrophoresis showed that 2 globulin increased, globulin increased, and globulin increased. IgG and IgM of LP type were increased by immunoglobulin assay; lactate dehydrogenase assay was increased; alkaline phosphatase assay was normal.
2. Histopathological examination Almost all low-grade malignant CBCL including CLL, PL (IC) and CBCC type tumor cells are B-cell infiltration or diffuse infiltration, that is, tumor cell clusters are mainly in the middle and lower parts of the dermis, especially around blood vessels, often involving The subcutaneous tissue is dense, monomorphic infiltration, different sizes, clear boundaries, and a cell-free infiltration zone with no obvious vascular hyperplasia. Highly malignant CBCL (CB and IB) tumor cells are often diffusely infiltrated, without obvious boundaries, and can infiltrate into the collagen bundle in a single line, invading the appendages and blood vessel walls.
If conditions are possible, further examinations such as histochemistry, cytochemistry, immunohistochemistry and electron microscopy can be more conducive to the diagnosis and typing of CBCL.

Skin B-cell lymphoma diagnosis

Clinically, for patients with monomorphic skin tumors in the short term, especially the reduction of hemoglobin in the blood, the possibility of CBCL should be highly vigilant. Accompanied by pathological examination of skin lesions, tumor cells are monomorphic, showing B cell infiltration or diffuse infiltration, which is generally diagnosed.

Skin B-cell lymphoma treatment

Primary CBCL can be cured by local radiotherapy or excision. If CBCL is a skin manifestation of systemic lymphoma, then chemotherapy is required.

Prognosis of cutaneous B-cell lymphoma

In the case of primary CBCL, the lesion is limited to the skin. Early and more aggressive combined chemotherapy should be sought for complete or long-lasting remission. The prognosis is better, and the 5-year survival rate is more than 90%. However, secondary CBCL or primary CBCL has involved lymph nodes, and the prognosis is poor. The course of disease is usually within 1 to 2 years.