Cutaneous T-Cell Lymphoma: From Clinical Suspicion to Confirmed Diagnosis

In this episode of Cutaneous Miscellaneous, host Nicholas Brownstone, MD, is joined by Ryan Svoboda, MD, for an in-depth review of cutaneous lymphomas. They begin with a boards review of the four primary cutaneous B-cell lymphomas—two indolent (follicle center, marginal zone) and two aggressive (diffuse large B-cell, intravascular B-cell). The discussion covers prognostic differences, biopsy strategies, key immunostains, helpful mnemonics for BCL markers, and notable associations such as Borrelia infection. In the main segment, the focus shifts to cutaneous T-cell lymphomas, particularly mycosis fungoides. Dr Svoboda shares diagnostic challenges, strategies to improve biopsy yield, and a practical scoring algorithm to interpret inconclusive pathology reports. They also review tips for diagnosing Sézary syndrome and highlight relevant NCCN guidelines. Tune in to the full episode for high-yield insights on recognizing, diagnosing, and managing both B-cell and T-cell cutaneous lymphomas in clinical practice.