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Blood, Vol. 95 No. 12 (June 15), 2000:
pp. 3922-3928
Primary cutaneous follicle center cell lymphoma with follicular
growth pattern
Lorenzo Cerroni,
Edith Arzberger,
Barbara Pütz,
Gerald Höfler,
Dieter Metze,
Christian A. Sander,
Christian Rose,
Peter Wolf,
Arno Rütten,
Jennifer M. McNiff, and
Helmut Kerl
From the Departments of Dermatology and Pathology,
University of Graz, Austria; the Department of Dermatology,
University of Münster; the Department of Dermatology, University
of Munich; the Department of Dermatology, University of
Würzburg; and Dermatopathologisches Gemeinschaftslabor,
Friedrichshafen, Germany; and the Department of Dermatology,
Yale University, New Haven, CT.
Cutaneous B-cell infiltrates showing a prominent follicular growth
pattern with germinal centers are thought by some authors to represent
either marginal zone lymphomas with reactive germinal centers or
pseudolymphomas. To establish whether a true primary cutaneous
follicular lymphoma exists, we studied biopsies from 15 patients with
skin lesions characterized histopathologically by the presence of
B-cell infiltrates with follicular pattern. Staging investigations,
including bone marrow biopsy, were negative in all patients. All were
negative for bcl-2 protein expression and did not
present the t(14;18). In all biopsy specimens neoplastic follicles
showed 1 or more morphologic or immunophenotypic criteria of malignancy
(presence of a reduced mantle zone, absence of tingible body
macrophages, reduced proliferation rate). In 9 specimens a monoclonal
rearrangement of JH genes could be detected by polymerase chain reaction analysis. After laser beam microdissection, a band of
the same length could be observed in 6 probes from different follicles
from the same specimen, indicating the presence of the same monoclonal
population of follicle center cells. Follow-up examinations in all
patients revealed no evidence of extracutaneous spread (mean follow-up,
48.7 months). Our study demonstrates that primary cutaneous follicular
lymphoma represents a distinct entity of the cutaneous B-cell lymphomas.
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