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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. T-cell lymphoma starts in lymph tissue which is found throughout the body, such as in the spleen, tonsils, bone marrow, intestines, and skin. Most skin (cutaneous) lymphomas are T-cell lymphomas. Cutaneous T-cell lymphoma 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 2 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 can look like other skin conditions. Make sure to see your healthcare provider 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 the skin

  • There are a small number of Sezary (lymphoma) cells in the blood

  • Lymph nodes are normal (not swollen or enlarged)

Stage II

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

  • There are a small number of Sezary cells in the blood

  • Lymph nodes are enlarged, but don't contain cancer cells

Or

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

  • Lymph nodes are normal or larger than normal, but don't contain cancer cells

  • There are a small number of Sezary cells in the blood

Stage III

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

  • Lymph nodes are normal or larger than normal, but don't contain cancer cells

  • There may be a small number of Sezary cells in the blood or there may be none

Stage IV

  • Skin is dry, red, scaly, or bumpy, and may have tumors on any amount of the skin surface

  • There may be many Sezary cells in the blood or there may be none

  • Lymph nodes are enlarged and contain cancer cells

Or

  • Cancer has spread  to other organs, such as the liver or spleen

Diagnosing cutaneous T-cell lymphoma

Your healthcare 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 taken to look for lymphoma cells. This helps to figure out 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 taken by mouth or injected into a vein so they can reach cancer cells all over the body. 

  • 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 a shot (injection).

  • Radiation therapy. This treatment uses X-rays to kill cancer cells and shrink tumors. Total skin electron beam therapy (or TSEBT) may be used to treat skin lymphoma.

  • Photodynamic therapy. This uses certain types of UV (ultraviolet) light and medicines called psoralens to kill cancer cells.

  • Extracorporeal photopheresis (or ECP). This therapy is used to kill lymphoma cells in the blood. The blood is sent through a machine that exposes it to a special UV (ultraviolet) 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 healthcare provider to find out if there are any clinical trials you should consider.

Online Medical Reviewer: Cunningham, Louise, RN
Online Medical Reviewer: Stump-Sutliff, Kim, RN, MSN, AOCNS
Date Last Reviewed: 12/1/2016
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