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Cutaneous T-Cell Lymphoma

What is cutaneous T-cell lymphoma?

Cutaneous T-cell lymphoma is a disease caused when T-lymphocytes become malignant and affect the skin. T-lymphocytes are the infection-fighting white blood cells in the lymph system that kill harmful bacteria in the body, among other things. Cutaneous T-cell lymphoma usually is a slow-growing cancer that often develops over many years. The two most common types of cutaneous T-cell lymphoma are mycosis fungoides and the Sezary syndrome.

What are the stages of cutaneous T-cell lymphoma?

Symptoms of cutaneous T-cell lymphoma depend on the stage of the cancer (how far it has spread). The following are the most common signs and symptoms of mycosis fungoides and the Sezary syndrome. (Other cutaneous T-cell lymphomas are staged slightly differently:

Stage

Signs and symptoms

Stage I

  • Dry, red, scaly patches, plaques (thick lesions), or bumps on skin (cover less than or at least 10 percent of the skin surface), but no tumors (the lesions larger than 1 centimeter wide) 

  • Lymph nodes are normal

Stage II

  • Dry, red, scaly patches, plaques, or bumps on skin (cover up to 80 percent of the skin surface), but no tumors. Lymph nodes are enlarged, but do not contain cancer cells.

or

  • At least one tumor on skin is one centimeter or more across. Lymph nodes are normal or larger than normal, but do not contain cancer cells.

Stage III

  • Most of the skin (at least 80 percent) is dry, red, scaly, or bumpy, and may have tumors

  • Lymph nodes are normal or larger than normal, but do not contain cancer cells

  • There may be a small number of lymphoma cells in the blood 

Stage IV

  • Skin is dry, red, scaly, or bumpy, and may have tumors (any amount of the skin surface can be involved) 

  • There are many lymphoma cells in the blood 

or

  • Cancer has spread to the lymph nodes and/or to other organs, such as the liver or spleen

The symptoms of cutaneous T-cell lymphoma may resemble other dermatological conditions. Always consult your doctor for a diagnosis.

How is cutaneous T-cell lymphoma diagnosed?

In addition to a medical history and physical examination, a physician may order a biopsy of a skin tumor or lymph node to confirm the diagnosis. A biopsy is a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present. The lymph nodes, bone marrow, and blood may also be sampled to look for lymphoma cells to help determine the stage if the disease.

Treatment for cutaneous T-cell lymphoma

Specific treatment for cutaneous T-cell lymphoma will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Type of T-cell lymphoma 

  • Extent and location of the disease

  • Your tolerance for specific medications, procedures, and therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Chemotherapy. This is treatment with drugs to destroy cancer cells. Drugs may be put on the skin as a cream or gel or injected into a vein. 

  • Other drug therapies (retinoids, corticosteroids, targeted drugs). Some are applied to the skin, while others are taken by mouth or given as an injection 

  • Radiation therapy. This therapy uses a radiation machine that emits X-rays to kill cancer cells and shrink tumors.

  • Photodynamic therapy. This therapy uses a certain type of light and a special chemical to kill cancer cells.

Clinical trials are currently being conducted using biological therapy, also called biological response modifier therapy, or immunotherapy. Biological therapy tries to get your own body to fight cancer by using materials made by your own body, or made in a laboratory, to boost, direct, or restore your body's natural defenses against disease.

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