Radiotherapy of primary cutaneous follicle center lymphoma: case report and review of literature

Romana Ceovic,Kresimir Kostovic,Jaka Rados,Sandra Marinovic Kulisic,Ivana Jovanovic,Davorin Loncaric,Ivo Radman,Snjezana Dotlic

doi:10.1186/1748-717x-8-147

Abstract

Primary cutaneous follicle center lymphoma is an indolent primary cutaneous B-cell lymphoma originating from the follicle center cells, composed of a combination of centrocytes (small and large cleaved cells) and centroblasts (large noncleaved cells) with a follicular, follicular/diffuse, or diffuse growth pattern. Lesions are mostly located on the head, neck and trunk. A case is presented of a 56-year-old male patient with primary cutaneous follicle center lymphoma, with lesions involving the skin of the back, shoulders, presternal area and right forearm. As the patient presented a disseminated cutaneous form of the disease that involved several anatomical regions, complete work-up was followed by superficial fractionated radiotherapy of eight fields in VI expositions, with total irradiation dose of 1400 cGy upon the following fields: right and left pectoral region, left and right shoulders, right suprascapular region, and proximal third of the right forearm. Total irradiation dose applied upon each field for the lesions located on the left and right side of the back was 1500 cGy. This therapy resulted in significant reduction of visible tumor. The patient was regularly followed up on outpatient basis for 12 months of radiotherapy, being free from local recurrence and systemic spread of the disease.

Highlights

Primary cutaneous follicle center lymphoma (PCFCL) can be defined as neoplastic proliferation of the follicle germinal center cells limited to the skin
In most patients with solitary or multiple lesions generally localized on the head and trunk, therapy of choice is radiotherapy based on histologic classification according to the growth pattern and number of blast cells, and the prognosis is good in these patients [1,4,13,14,15,46,47,48,49,50,51]
There is no substantial prognosis difference between tumor lesions with a follicular growth pattern and tumor lesions with diffuse growth pattern [1,4], but some studies indicate that poorer prognosis should be expected in PCFCL cases with diffuse growth pattern, pronounced bcl-2 expression and histologically visible large cells [70]

Summary

Introduction

Background Primary cutaneous follicle center lymphoma (PCFCL) can be defined as neoplastic proliferation of the follicle germinal center cells limited to the skin. PCFCL is a localized disease rarely associated with extracutaneous dissemination [18]. The histopathologic picture of PCFCL varies depending on the duration, stage of lesion growth as revealed by biopsy specimen, and localization [15,19].

Results

Conclusion