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Paediatric cutaneous lymphomas: a review and comparison with adult counterparts
W Kempf1,2, D V Kazakov1,3, I E Belousova4
1Kempf und Pfaltz, Histologische Diagnostik, Zürich, Switzerland.
Insights
Primary cutaneous lymphomas (CL) in children are rare, with mycosis fungoides and lymphomatoid papulosis being most common. Paediatric CL often differs from adult forms, especially B-cell lymphomas, requiring specialized care.
Area of Science:
- Dermatology
- Oncology
- Paediatrics
Background:
- Primary cutaneous lymphomas (CL) in children are rare, with limited understanding of their unique characteristics compared to adult CL.
- Existing research has not extensively focused on the clinicopathological presentation, behavior, and prognosis of pediatric CL.
Purpose of the Study:
- To investigate the clinicopathological features, behavior, and prognosis of primary cutaneous lymphomas in children.
- To compare pediatric CL with their adult counterparts and identify differences in disease spectrum and presentation.
Main Methods:
- An extensive literature search was conducted using PubMed/MEDLINE (January 1995 - July 2014).
- Cases of pediatric CL from institutional records (31 children) were analyzed.
- Clinicopathological data was reviewed for identified cases and literature reports.
Main Results:
- Mycosis fungoides and lymphomatoid papulosis are the most prevalent CL types in children.
- Certain CL entities, like cutaneous diffuse large B-cell lymphoma leg type and Sézary syndrome, have not been reported in children.
- Aggressive B-cell lymphomas, precursor lymphoblastic lymphomas, and blastic plasmacytoid dendritic cell neoplasm are common in children, often secondary skin involvement.
Conclusions:
- Most pediatric lymphomas share similar clinicopathological features and course with adult counterparts, especially cutaneous T-cell lymphomas.
- The spectrum of cutaneous B-cell lymphomas in children significantly differs from that in adults.
- Optimal diagnosis and treatment necessitate close collaboration with pediatric hematopathologists and oncologists.
Abstract:
Primary cutaneous lymphomas (CL) in children is rare. Only a few studies focused specifically on paediatric CL and therefore little is known whether primary CL in children are similar to or different from their adult counterparts with respect to the clinicopathological presentation, behaviour and prognosis. An extensive literature search using PubMed/MEDLINE from January 1995 through July 2014 was undertaken for articles reporting cases of paediatric CL. In addition, we identified 31 children with CL in our institutions. Mycosis fungoides and lymphomatoid papulosis are the two most prevalent lymphoma forms in children. A few entities of cutaneous lymphomas such as cutaneous diffuse large B-cell lymphoma leg type, and Sézary syndrome have not been reported so far in children. Other lymphoma entities such as hydroa vacciniforme-like lymphoma are mostly seen in certain geographic areas (Asia, Central and South America). In the paediatric population, low-malignant indolent forms such as primary cutaneous marginal zone lymphoma and primary cutaneous follicle centre lymphoma are very rare, whereas the more aggressive forms of B-cell lymphomas, precursor lymphoblastic lymphomas, and blastic plasmacytoid dendritic cell neoplasm are the most common forms in children, mostly involving the skin secondarily. Most paediatric lymphomas have similar clinicopathological features and course as their adults counterparts, particularly in the group of cutaneous T-cell lymphomas. The spectrum of cutaneous B-cell lymphomas in children significantly differs from the one in adults. Diagnostic work-up and treatment of paediatric patients with lymphomas are best achieved in close collaboration with paediatric haematopathologists and oncologists.
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