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Primary Cutaneous B-cell Lymphomas: FL, MCL, Differential Diagnosis

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Follicular Lymphoma and Mantle Cell Lymphoma

Part of the book series: Molecular and Translational Medicine ((MOLEMED))

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Abstract

Primary cutaneous B-cell lymphomas comprise a small group of lymphoproliferative disorders that range in behavior from indolent, localized skin-limited tumors with survival approximating 100% to aggressive malignancies with a propensity for extracutaneous dissemination. The relatively indolent primary cutaneous marginal zone lymphoma and primary cutaneous follicle center lymphoma both show significant overlap with cutaneous lymphoid hyperplasias and often require strong correlations with clinical findings in order to establish a definitive diagnosis. These lymphomas can exhibit significant histologic and sometimes molecular overlap with their extracutaneous counterparts, MALT lymphoma and follicular lymphoma, respectively. A multidisciplinary evaluation may therefore be required in order to permit for proper categorization. Furthermore, these entities must be distinguished from other mature B-cell lymphomas that can involve the skin, including chronic lymphocytic leukemia/small cell lymphoma and mantle cell lymphoma. At the opposite end of the clinical spectrum is primary cutaneous diffuse large B-cell lymphoma, leg type, which is occasionally challenging to distinguish from follicle center lymphomas with a preponderance of large cells and may be phenotypically identical to some of the extracutaneous diffuse large B-cell lymphomas that secondarily involve the skin. The distinction of leg-type lymphoma from follicle center lymphoma is critical since leg-type lymphomas are clinically aggressive, and there is ongoing discussion regarding how to classify rare, morphologically or immunophenotypically ambiguous large cell lymphomas. Our present understanding of the histomorphologic, immunophenotypic, and molecular aberrances underpinning these unusual and diagnostically challenging lymphoproliferative entities is discussed herein with an emphasis on differential diagnosis.

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  1. Pathology and Laboratory Medicine, Dermatopathology Fellowship Program, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, USA

    Robert E. LeBlanc

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  1. Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, USA

    Prabhjot Kaur

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LeBlanc, R.E. (2020). Primary Cutaneous B-cell Lymphomas: FL, MCL, Differential Diagnosis. In: Kaur, P. (eds) Follicular Lymphoma and Mantle Cell Lymphoma. Molecular and Translational Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-49741-5_3

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