Diagnosing and treating Cutaneous T-cell lymphoma
Cutaneous T-cell lymphoma first affects the skin and then spreads to other parts of the body, like internal organs. The signs of the disease are itchy dark patches on the skin that progressively transform into mushroom shaped tumors, that is why the disease is also known as Mycosis Fungoides.
A particular form of the cutaneous T-cell lymphoma is the Sézary syndrome. Signs of this disease are: an overall redness of the skin, small bumpy tumors, and the skin is atrophic. At physical examination doctors see that the lymph nodes have swollen and discover an increased number of malign lymphocytes.
Cutaneous T-cell lymphoma is not the same thing with adult T-cell leukemia or peripheral T-cell lymphomas. These are more aggressive skin affections and require different treatment.
Generally, patients go to the doctor because they have an itchy red skin zone that bothers them for some time. If the disease has already spread outside the skin, the patient might feel its lymph nodes swollen.
Because mistaken cutaneous T-cell lymphoma with other skin diseases is quite easily, doctors prefer to perform a tissue biopsy, meaning that they remove the suspected tissue and analyze it in the laboratory to see if there is cancer present and in what stage of evolvement it is. For staging the disease they use that TNM classification: from T1 to T4- the spread of the tumors on the skin; N0 to N3- the involvement of the lymph nodes; M1 or not M0 if there are metastases present or not. Biopsy is the most accurate way of diagnosing cutaneous T-cell lymphoma that is why all doctors must request it when suspecting such a disease.
When studying the tissue there can be seen abnormal cells, and by performing a Southern blot analysis there will be observed changes of the gene that encodes the T-cell receptors.
The treatment will be adjusted depending on the affection’s evolution. There can be used chemotherapy, ultraviolet ‘A’ light exposure and total skin electron beam radiation if metastases are present.
Chemotherapy tries to stop cancerous cells from growing or dividing. There can be used oral drugs or drugs injected into the vein or muscle that will reach the cancer cells by entering the bloodstream, and is called systemic chemotherapy. Another type of chemotherapy is the regional chemotherapy when the chemotherapy is placed directly into the cancerous area.
Also, a patient can participate at a clinical trial where treatment with multiple agent chemotherapy is done.
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