title: Clinicopathologic features of early lesions of primary cutaneous follicle center lymphoma, diffuse type: implications for early diagnosis and treatment.
abstract: BACKGROUND
  Data on early lesions of primary cutaneous follicle center lymphoma (PCFCL), diffuse type are very limited.
  
  
  OBJECTIVE
  We sought to elucidate the early clinicopathologic features of PCFCL, diffuse type.
  
  
  METHODS
  Clinical, histologic, immunohistologic, molecular, and fluorescence in situ hybridization data from 24 patients with early lesions of PCFCL, diffuse type (male:female = 19:5; median age: 57 years) were determined.
  
  
  RESULTS
  Lesions consisted mostly of solitary or clustered papules and small nodules located on the trunk (21 cases), arm (two cases), and scalp (one case). In 3 patients small papules were located at a distance from the main affected area. All biopsy specimens from early lesions showed aggregates of medium and large centrocytes admixed with small lymphocytes without formation of clear-cut lymph follicles. Staining for Bcl-2 was positive in only 7 cases, one revealing also a rearranged BCL2 signal by fluorescence in situ hybridization. Data on treatment and follow-up were available for 22 patients. At last examination 13 patients were in complete remission (median follow-up: 60 months), 6 were alive with skin disease alone (median follow-up: 60 months), two were alive with skin disease and bone-marrow or lymph node involvement, respectively, and one died of unrelated causes while in complete remission.
  
  
  CONCLUSIONS
  The retrospective study and the fact that patients were treated at different institutions are limitations.
  
  
  CONCLUSIONS
  Early lesions of PCFCL, diffuse type present with characteristic clinicopathologic features. Dermatologists should be alert particularly to the early clinical manifestations of this lymphoma and to the presence of small, inconspicuous lesions at a distance from the main affected area in order to plan treatment properly.
authors.affiliation: Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gulia
authors.forename: Andrea
authors.initials: A
authors.lastname: Saggini
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiesner
authors.forename: Regina
authors.initials: R
authors.lastname: Fink-Puches
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Argenyi
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Cornelia S L
authors.initials: CS
authors.lastname: Müller
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Vale
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D001706:Biopsy; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D019254:Genes, bcl-2; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000473:pathology / Q000601:surgery; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D012535:Scalp; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D060726:Torso
chemical_list: D014408:Biomarkers, Tumor