Cutaneous malignant lymphoma

Abstract

The skin as the first site of non-Hodgkin's lymphoma is uncommon. Between 1967-1982 only 61 evaluable patients were seen; lymphoma was confined to the skin in 43. Most histological subtypes of non-Hodgkin's lymphoma were represented with diffuse histiocytic tumors accounting for 28 (46%). Overall, there was a 5-year survival rate of 52% with a median of 75 months. For patients with disseminated lymphoma involving the skin, the median survival was 18 months and there were no 10 year survivors. Patients with disease confined to the skin had 5 and 10-year survival rates of 62 and 57%, and a median survival of 159 months. Significant prognostic indicators included the site and bulk of tumor, but not the histological subtype. For small bulk localized tumors radiotherapy achieved local control in all patients and an over 80% five-year relapse-free rate. We conclude that lymphomas confined to the skin can be adequately treated by radiotherapy, whereas disseminated tumors require systemic therapy in addition. The management of bulky cutaneous lymphoma remains controversial.