Prognostic Categorization of Lymphoproliferative Disorders of the Skin A New and Clinically Oriented Approach

G√ľnter Burg, Sonja Michaelis, Philippa Golling, and Werner Kempf

Department of Dermatology, University Hospital, Zurich, Switzerland

The continuous increase of knowledge has led to controversies and produced a plethora of new classifications, presenting the clinician with a dilemma. Many cutaneous lymphomas (CL), in particular B-cell lymphomas, share common clinical and prognostic features, but differ in regard to morphology. In contrast, there are CL forms, especially lymphoproliferative disorders of T-cell origin with similar morphologic findings, but distinct clinical and prognostic features which should therefore not lumped together. Since most classifications do not provide information about the biologic behavior of CL to the clinician, we propose a new categorization for CL based on prognostic and biological features (Table 1). In analogy to the Working Formulation, different clinicopathologic entities are grouped into classes corresponding to their biological behavior, i.e., grade (low, intermediate, or high) of malignancy.

The proposed categories include (a) pseudolymphoma, (b) abortive, and (c) malignant (divided into low-grade and high-grade malignant forms) lymphoproli-ferative disorders. These categories are defined as follows.

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