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Cutaneous T-cell Lymphoma (CTCL) is a rare type of non-Hodgkin lymphoma (NHL) that primarily affects the skin.
Like all lymphomas, CTCL originates from abnormal lymphocytes—immune cells produced in the bone marrow and found in the blood and lymph tissue. Lymphoma develops when these cells grow and multiply uncontrollably, which can lead to the formation of tumours.
CTCL is the most common form of skin lymphoma, accounting for approximately 2% to 3% of all non-Hodgkin T-cell lymphoma cases. Subtypes of CTCL include:
Most CTCLs are chronic and slow-growing; they are generally treatable but not typically curable and are usually not life-threatening. About 70% of patients with Mycosis fungoides are diagnosed at an early stage and, with treatment, may have a normal life expectancy.
While the exact cause is unknown, certain factors can increase a person's risk:
Symptoms can vary by the specific type and stage of the cancer. Since the symptoms of cutaneous T-cell lymphoma can mimic other skin conditions, such as eczema or chronic dermatitis, diagnosis is often delayed.
CTCL typically presents as a scaly, itchy, red rash that may thicken or develop into tumours on the skin. Patients may also have swollen lymph nodes.
Common symptoms include:
Other symptoms can include severe itching, unexplained weight loss, fever, and sweating.
Symptoms of NHL vary widely based on the type of disease:
Develops slowly. Patients may experience painless swelling of lymph nodes (commonly in the neck or over the collarbone), which may wax and wane. If the lymphoma spreads outside the lymph nodes, discomfort may occur in the affected area.
Grows more quickly and tends to cause more pronounced symptoms:
If you experience any of these symptoms, it is important to discuss them with your doctor.
An accurate and precise diagnosis is crucial for doctors to select the most effective course of treatment, significantly impacting the chances of a successful outcome.
At SSCHRC, our group of experts is highly experienced in diagnosing non-Hodgkin lymphoma. We are one of the few cancer centres with specialised doctors, known as hematopathologists, who focus on diagnosing lymphomas and other blood cancers, on our care team. Their high level of expertise and use of modern equipment help determine the precise extent of the disease, which is vital for accurate diagnosis and successful treatment.
If symptoms suggest non-Hodgkin lymphoma, your doctor will conduct an examination and review your medical history. One or more of the following tests may be used to confirm a diagnosis, check for spread, or monitor treatment effectiveness:
A small piece of tissue is removed from a lymph node (sometimes the entire node) and examined under a microscope.
If diagnosed with non-Hodgkin lymphoma, your doctor will determine the stage of the disease, which classifies how much disease is in the body and where it has spread. This information is key to deciding on the best treatment.
(Source: National Cancer Institute)
Involvement of only one lymph node region. If the cancer is confined to one organ outside the lymph node (e.g., skin, lung, brain), it is called extension, or E non-Hodgkin lymphoma.
Cancer is present in two or more lymph regions on one side of the diaphragm. If the cancer is in one lymph node region plus a nearby area or organ, it is considered E disease.
Non-Hodgkin lymphoma involves lymph nodes both above and below the diaphragm, or one node area and one organ on opposite sides of the diaphragm.
The lymphoma has spread outside the lymph nodes and spleen to one or more organs, such as the bone, bone marrow, or skin.
Each stage is further classified as A or B: A means the patient does not have systemic symptoms (fever, drenching sweats, or unexplained weight loss); B means the patient has one or more of these symptoms.
Treatment for lymphoma is highly customised and depends on several factors, including: the specific type of lymphoma, the stage and category of the disease, the symptoms, and the patient's age and general health. Every lymphoma and every patient is different. Our experts at SSCHRC focus solely on caring for patients with lymphoma to ensure customised treatment tailored to individual needs.
CTCL treatment often involves therapies directed at the skin:
For small, localised skin lesions, topical steroids (anti-inflammatory) or topical chemotherapy (to kill cancer cells) may be used.
Uses powerful, focused beams of energy to kill cancer cells and shrink tumours. Skin-directed, low-dose radiation is used, including Total Skin Electron Beam Therapy (TSEBT), which limits radiation exposure to internal organs and tissues.
Uses ultraviolet light to kill cancer cells, sometimes enhanced by photoactivating creams or pills.
A procedure where the patient's blood is routed through a machine that separates some white blood cells. These cells are treated with psoralen (a light-sensitive chemical), exposed to ultraviolet light, and then returned to the patient's body.
May include targeted therapy, immunotherapy, biologic agents, and innovative new treatments being tested in clinical trials.
SSCHRC is dedicated to helping people with NHL live longer, healthier lives and is making significant advancements in therapies that minimise side effects.
This is the most common treatment for NHL, killing fast-growing cells, including cancer cells. Due to the potential for lowering blood cell counts, a transfusion of blood cell growth factors may be necessary. Advanced methods, such as liposomal drug delivery, may be used to enhance effectiveness.
Uses focused energy beams to kill cancer cells. It may be used for early-stage lymphoma or to relieve symptoms like pain, but is rarely the sole treatment.
Drugs that help the body's own immune system fight the cancer. These may have fewer side effects than other treatments and can include:
May be recommended if NHL does not respond to chemotherapy or if it returns. It replaces defective or damaged blood cells, and may also be needed after certain types of chemotherapy that affect healthy blood and bone marrow cells.
This approach involves closely monitoring low-grade lymphomas without immediate active treatment, which can be appropriate for some patients.