Skin - Nonmelanocytic tumors
Lymphoma and related disorders
Follicular lymphoma - cutaneous

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 13 October 2016, last major update February 2011

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed search: Follicular lymphoma [title] cutaneous

Cite this page: Follicular lymphoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphomafollicularcutaneous.html. Accessed December 4th, 2016.
Definition / General
  • By definition, arises in skin with no known extracutaneous disease within 6 months of initial diagnosis
  • Note: this topic is identical to Lymphoma - B cell
Terminology
  • Also called primary cutaneous follicular cell lymphoma (PCFCL)
Etiology
Clinical Features
  • Localized papulonodular lesions, often in head, neck and trunk, with excellent prognosis (5 year survival of 95%)
  • Mean age 64 years
  • By definition, arises in skin with no known extracutaneous disease within 6 months of initial diagnosis
  • In Scottish Highlands, cutaneous B cell lymphomas (all subtypes) are associated with Borrelia burgdorferi (Lyme disease, Am J Surg Pathol 2000;24:1279)
Treatment
  • Radiation therapy for localized disease
  • Combination chemotherapy for multifocal disease
  • Antibiotics for Borrelia associated disease
  • Avoid overtreatment, as these tumors have an excellent prognosis
Clinical Images
Images hosted on other servers:

Secondary lesions on back

Clustered erythematous papules

Gross Description
  • Solitary or grouped papules, plaques or tumors
Micro Description
  • Has follicular, follicular and diffuse, diffuse or floral-like growth patterns
  • Follicular / nodular, follicular and diffuse, diffuse or floral-like growth patterns
  • Germinal center cytology of predominantly centrocytes (cleaved follicular cells) with admixed centroblasts (large transformed cells, Am J Surg Pathol 2001;25:875)
Micro Images
Images hosted on PathOut server:

Courtesy of Dr. Mark R. Wick:

Various images

BCL2



Images hosted on other servers:

CD 20+, BCL6+, Ki67+

Bottom heavy lymphoid infiltrate

Dense infiltrate

Neoplastic follicles

Centroblasts and centrocytes


CD10+

MIB1

Bcl2 negative

Nodular infiltrates

Centroblasts and centrocytes

Positive Stains
  • CD19, CD20, CD79a
  • Bcl6+ and usually CD10+ centrocytes and centroblasts
  • Similar to noncutaneous follicular lymphoma except that is commonly Bcl2 negative or has weaker staining than admixed T cells; compare with secondary cutaneous involvement by follicular lymphoma, which is Bcl2+ (J Clin Oncol 2007;25:1581)
Negative Stains
Molecular / Cytogenetics Description
Differential Diagnosis