Cutaneous lymphoma

Abstract

The most common type of cutaneous lymphoma is mycosis fungoides. Other types of cutaneous lymphomas are rare and include variants of mycosis fungoides, Sezary’s syndrome, lymphomatoid papulosis and cutaneous B-cell lymphomas. The histopathological diagnosis of cutaneous T-cell lymphomas may be extremely difficult and differentiation from inflammatory dermatoses is sometimes impossible. Together with the clinical picture, the often unspecific histopathological features may, however, lead to the correct diagnosis. RCM features in CTCL correlate well to histopathologic findings; scattered atypical cells within the epidermis, focal loss of the honeycomb pattern, bright and thickened intercellular demarcations and loss of the typical ringed appearance of dermal papillae are observed. The detection of intraepidermal aggregates of atypical lymphocytes, which correspond to the highly characteristic Pautrier’s microabscesses in histopathology, may enable a correct diagnosis without biopsy. Dermal structures are difficult to identify because of loss of detail and contrast below the papillary dermis in RCM. Variants of MF and lymphomatoid papulosis show similar, mostly unspecific RCM features.