Cutaneous T-Cell Lymphoma

Cutaneous T-cell lymphoma is a type of cancer. It starts in blood cells called T-lymphocytes. These are white blood cells that are part of your immune system. They normally fight infection in the body. The cancer then affects the skin (cutaneous). It causes scaly patches or bumps called lesions or tumors. The cancer is also known as lymphoma of the skin. It is a type of non-Hodgkin lymphoma.

Cutaneous T-cell lymphoma is usually a slow-growing cancer. It develops over many years. The two most common types of this cancer are mycosis fungoides and the Sezary syndrome.

Symptoms and stages of cutaneous T-cell lymphoma

The symptoms of cutaneous T-cell lymphoma depend on how far the cancer has spread (stage). The symptoms of can look like other skin conditions. Make sure to see your doctor for a diagnosis. The following are the most common signs and symptoms of mycosis fungoides and the Sezary syndrome:

Stage

Signs and symptoms

Stage I

  • Dry, red, scaly patches, plaques (thick lesions), or bumps on skin cover less than  80 percent of the skin surface

  • No lesions larger than 1 centimeter (cm) wide, known as tumors

  • Lymph nodes are normal

Stage II

  • Dry, red, scaly patches, plaques, or bumps on skin cover up to 80 percent of the skin surface

  • No lesions larger than 1 cm wide (tumors) 

  • Lymph nodes are enlarged, but do not contain cancer cells.

Or

  • At least one tumor on skin is 1 cm or more wide

  • 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 on any amount of the skin surface

  • 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

Diagnosing cutaneous T-cell lymphoma

Your health care provider will ask about your medical history and give you a physical exam. You may also have a biopsy of a skin tumor or lymph node. This is a small sample of tissue that is taken with a needle or minor surgery. The tissue is then checked in a lab for cancer cells. A biopsy will confirm the diagnosis. You may also have samples of lymph nodes, bone marrow, and blood take to look for lymphoma cells. This helps to learn the stage of the disease.

Treatment for cutaneous T-cell lymphoma

Treatment may include:

  • Chemotherapy. This is treatment with medicines to kill cancer cells. Medicines may be put on the skin as a cream or gel. Or they may be injected into a vein. 

  • Other types of medicine. These may include retinoids, corticosteroids, targeted medicine, or immune therapy. Some of these are applied to the skin. Others are taken by mouth or given as an injection.

  • Radiation therapy. This treatment uses X-rays to kill cancer cells and shrink tumors.

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

  • Extracorporeal photopheresis. This therapy is used to kill lymphoma cells in the blood. The blood is sent through a machine that exposes it to a special ultraviolet (UV) light. The light kills the lymphoma cells. The blood is then returned to the body.

Clinical trials for new treatments

Researchers are always finding new ways to treat cancer. These new methods are tested in clinical trials. Talk with your doctor to find out if there are any clinical trials you should consider.

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