Gunter Burg and Werner Kempf

Department of Dermatology, University Hospital, Zurich, Switzerland

Nodal lymphomas may go through a preneoplastic phase, but the initial subtle findings are clinically hidden, whereas in cutaneous lymphomas (CL), the tiniest changes can be seen and monitored clinically or with sequential biopsies during all stages of disease progression. Especially in cutaneous T cell lymphomas, there may be a long preneoplastic phase, which precedes the transition to overt malignant lymphoma. The life expectancy of patients suffering from these preneoplastic conditions is unaffected (1). These preneoplastic conditions are most interesting with respect to questions of the pathogenesis and of the early molecular changes as a normal lymphocyte transforms into a neoplastic cell.

Thus, CL reflect the whole spectrum of pathogenetic events in cancerogenesis. In our concept, the preneoplastic processes depend on a persistent antigenic stimulation and on a specific homing microenvironment. During disease progression and transformation into overt lymphoma, the tumor cells become less dependent on those stromal, cellular, or soluble microenvironmental factors.

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