Role of imaging in low-grade cutaneous B-cell lymphoma presenting in the skin

J Am Acad Dermatol. 2019 Oct;81(4):970-976. doi: 10.1016/j.jaad.2019.01.037. Epub 2019 Jan 29.


Background: Whole-body imaging is the current standard of care for staging all patients presenting with skin lesions of B-cell lymphomas (BCLs), regardless of skin disease extent; however, supporting data are lacking.

Objective: To determine the clinical utility of imaging in the detection of systemic involvement in low-grade cutaneous BCLs in the skin.

Methods: Retrospective cohort analysis of patients presenting with cutaneous lesions of BCLs at Memorial Sloan Kettering Cancer Center and Stanford University during 1997-2016.

Results: At initial staging, of the 522 patients, extracutaneous disease was noted in 3.6% and 8.8% of patients with marginal zone lymphoma (MZL, n = 306) and follicle center lymphoma (FCL, n = 216) histology, respectively. In patients with systemic involvement, imaging alone identified 81.8% (9/11) of MZL cases and 89.4% of follicular lymphoma cases. In primary cutaneous MZL, 1.7% of patients subsequently had extracutaneous involvement (median follow-up 45 months), and in primary cutaneous FCL. 3.0% subsequently had extracutaneous involvement (median follow-up 47 months).

Limitations: This was a retrospective study.

Conclusion: Imaging is effective at identifying patients with systemic involvement in indolent BCLs present in the skin; however, incidence is low. After negative initial staging, primary cutaneous MZL patients may be followed clinically without routine imaging.

Keywords: imaging; primary cutaneous B-cell lymphoma; prognosis; systemic involvement of cutaneous B-cell lymphoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Child
  • Female
  • Humans
  • Lymphoma, B-Cell, Marginal Zone / diagnostic imaging*
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, Follicular / diagnostic imaging*
  • Lymphoma, Follicular / pathology
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging*
  • Neoplasms, Second Primary / diagnostic imaging*
  • Neoplasms, Second Primary / pathology
  • Positron Emission Tomography Computed Tomography
  • Retrospective Studies
  • Skin / pathology
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology*
  • Survival Rate
  • Whole Body Imaging
  • Young Adult