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Cutaneous follicular lymphoma.

C F Garcia, L M Weiss, R A Warnke

The American Journal of Surgical Pathology

|July 1, 1986

Summary

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Cutaneous follicular lymphomas, a type of non-Hodgkin lymphoma affecting the skin, can be challenging to diagnose. Accurate diagnosis requires adequate deep biopsies and can be aided by immunohistologic studies.

Area of Science:

Dermatology
Oncology
Pathology

Background:

Cutaneous follicular lymphoma (CFL) presents unique diagnostic challenges.
Morphological assessment alone can be insufficient, especially with small or superficial biopsies.

Purpose of the Study:

To evaluate clinical, histological, and immunological features of 15 CFL cases.
To highlight diagnostic difficulties and the importance of biopsy adequacy.

Main Methods:

Clinical evaluation of 15 patients with cutaneous follicular lymphoma.
Histological examination of skin biopsies.
Immunohistological studies to confirm B cell lineage and immunoglobulin expression.

Main Results:

Nodular configuration was common, often in deep dermis/subcutis.

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Histological diagnosis was difficult in 4/15 cases due to morphology and inflammation.

High proportion of immunoglobulin-negative cases (8/15), particularly in primary CFL (6/9).

Immunohistology confirmed B cell origin and identified monotypic immunoglobulin light chains in expressing cases.

Conclusions:

Adequate, deep biopsies are crucial for accurate CFL diagnosis.
Histological criteria similar to lymph node follicular lymphoma are applicable.
Immunohistologic studies are valuable adjuncts for CFL diagnosis, especially for immunoglobulin-negative cases.