Yıl: 2020 Cilt: 30 Sayı: 2 Sayfa Aralığı: 56 - 62 Metin Dili: Türkçe DOI: 10.5336/dermato.2019-72771 İndeks Tarihi: 17-12-2020

Primer Kutanöz Lenfomalarda Tanı ve Evreleme

Öz:
Primer kutanöz lenfomalar, kutanöz T hücreli ve B hücreli lenfomaların heterojen bir grubudur. Tanı aldıklarında çoğunlukla deriyelokalizedirler. Yaklaşık %80’ini kutanöz T hücreli lenfomalar, %20’sinikutanöz B hücreli lenfomalar oluşturmaktadır. Tanı için klinik, histopatoloji, immünfenotiplendirme ve gen rearranjman analizleri birliktedeğerlendirilmelidir. En sık görülen kutanöz T hücreli lenfoma mikozis fungoidestir. Klinik olarak yama, plak ve tümöral lezyonlar görülür.Histopatolojik incelemede atipik lenfositler, epidermotropizm, Pautriermikroapseleri tespit edilir. Fakat histopatolojik bulgular ve immünfenotiplendirme karakteristik olmadığında, erken evre mikozis fungoideste tanı zorlukları yaşanmaktadır. Eritrodermi ile karakterize Sezarysendromunda, Sezary hücreleri deride, lenf nodunda ve periferik kandagörülür. Primer kutanöz CD30+ lenfoproliferatif hastalıklar ise kutanöz T hücreli lenfomaların 2. büyük grubunu oluşturur. Bunlar dışındanadir görülen diğer primer kutanöz T hücreli lenfomalar için klinik, histopatolojik, immünfenotiplendirme özellikleri ile ayırıcı tanıya gidilir.Primer kutanöz marjinal zon lenfoma, primer kutanöz folikül merkezhücreli lenfoma, primer kutanöz diffüz büyük B hücreli lenfoma, bacaktipi ise başlıca 3 primer kutanöz B hücreli lenfomadır. Primer kutanözlenfoma hastalarında evreleme yapılması hastaların takibi, prognozuve tedavisi için önemlidir. Mikozis fungoides ve Sezary sendromu içinTNMB sınıflandırması kullanılır. Derinin değerlendirilmesi için lezyonların klinik özellikleri ve kapladıkları yüzey alan önemlidir. Anormal lenf nodlarının incelenmesi için eksizyonel biyopsi önerilir. Lenfnodlarında, prognoz nodal yapının silinmesi ile ilişkilidir. Diğer primerkutanöz lenfomaları evrelendirmek için TNM sınıflandırması kullanılır ve santral lenf nodları değerlendirilir.
Anahtar Kelime:

Diagnosis and Staging in Primary Cutaneous Lymphomas

Öz:
Primary cutaneous lymphomas are a heterogeneous group of cutaneous T and B cell lymphomas. They present in the skin with no evidence of extracutaneous disease at the time of diagnosis. Cutaneous T cell lymphomas represent approximately 80% and cutaneous B cell lymphomas represent approximately 20% of all primary cutaneous lymphomas. Clinical properties, histopathology, immunophenotyping and gene rearrangement analyzes are evaluated for the diagnosis. Mycosis fungoides represents the most common type of cutaneous T cell lymphomas and presents in the skin as patches, plaques and tumors. Histopathological examination reveals atypical lymphocytes, epidermotropism and Pautrier microabscesses. However, when histopathological findings and immunophenotyping are not characteristic, diagnosis of early mycosis fungoides could be difficult. Sezary syndrome is characterized by erythroderma and Sezary cells are present in the skin, lymph nodes and peripheral blood. Primary cutaneous CD30+ lymphoproliferative disorders represent the second most common group of cutaneous T cell lymphomas. For other rare primary cutaneous T cell lymphomas, differential diagnosis is made with clinical, histopathological and immunophenotyping features. Primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type are 3 types of primary cutaneous B-cell lymphomas. Staging is important for the follow up, prognosis and treatment of the patients with primary cutaneous lymphomas. Staging of mycosis fungoides and Sezary syndrome is based on TNMB classification. Clinical features and surface area of the lesions are important for the evaluation of the skin. Excisional biopsy is recommended for examination of abnormal lymph nodes. Prognosis regarding lymph nodes is related to effaced nodal architecture. TNM classification is used for staging other primary cutaneous lymphomas and central lymph nodes are also evaluated.
Anahtar Kelime:

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APA Pancar Yuksel E (2020). Primer Kutanöz Lenfomalarda Tanı ve Evreleme. , 56 - 62. 10.5336/dermato.2019-72771
Chicago Pancar Yuksel Esra Primer Kutanöz Lenfomalarda Tanı ve Evreleme. (2020): 56 - 62. 10.5336/dermato.2019-72771
MLA Pancar Yuksel Esra Primer Kutanöz Lenfomalarda Tanı ve Evreleme. , 2020, ss.56 - 62. 10.5336/dermato.2019-72771
AMA Pancar Yuksel E Primer Kutanöz Lenfomalarda Tanı ve Evreleme. . 2020; 56 - 62. 10.5336/dermato.2019-72771
Vancouver Pancar Yuksel E Primer Kutanöz Lenfomalarda Tanı ve Evreleme. . 2020; 56 - 62. 10.5336/dermato.2019-72771
IEEE Pancar Yuksel E "Primer Kutanöz Lenfomalarda Tanı ve Evreleme." , ss.56 - 62, 2020. 10.5336/dermato.2019-72771
ISNAD Pancar Yuksel, Esra. "Primer Kutanöz Lenfomalarda Tanı ve Evreleme". (2020), 56-62. https://doi.org/10.5336/dermato.2019-72771
APA Pancar Yuksel E (2020). Primer Kutanöz Lenfomalarda Tanı ve Evreleme. Türkiye Klinikleri Dermatoloji Dergisi, 30(2), 56 - 62. 10.5336/dermato.2019-72771
Chicago Pancar Yuksel Esra Primer Kutanöz Lenfomalarda Tanı ve Evreleme. Türkiye Klinikleri Dermatoloji Dergisi 30, no.2 (2020): 56 - 62. 10.5336/dermato.2019-72771
MLA Pancar Yuksel Esra Primer Kutanöz Lenfomalarda Tanı ve Evreleme. Türkiye Klinikleri Dermatoloji Dergisi, vol.30, no.2, 2020, ss.56 - 62. 10.5336/dermato.2019-72771
AMA Pancar Yuksel E Primer Kutanöz Lenfomalarda Tanı ve Evreleme. Türkiye Klinikleri Dermatoloji Dergisi. 2020; 30(2): 56 - 62. 10.5336/dermato.2019-72771
Vancouver Pancar Yuksel E Primer Kutanöz Lenfomalarda Tanı ve Evreleme. Türkiye Klinikleri Dermatoloji Dergisi. 2020; 30(2): 56 - 62. 10.5336/dermato.2019-72771
IEEE Pancar Yuksel E "Primer Kutanöz Lenfomalarda Tanı ve Evreleme." Türkiye Klinikleri Dermatoloji Dergisi, 30, ss.56 - 62, 2020. 10.5336/dermato.2019-72771
ISNAD Pancar Yuksel, Esra. "Primer Kutanöz Lenfomalarda Tanı ve Evreleme". Türkiye Klinikleri Dermatoloji Dergisi 30/2 (2020), 56-62. https://doi.org/10.5336/dermato.2019-72771