Lymphoma?

[sweets1974]

I was just diagnoised with PLC Pityriasis Lichenoides Chronica (skin biopsy)

Diagnosis:
Right anterior thigh - patchy lichenoid and slight spongiotic dermatitis with rare eosinophils
Note: The differential diagnosis includes a drug eruption, pityriasis lichenoides spectrum disorder and, less likely, pityriasis rosea.

Microscopic description:
There are slight hyperkeratosis including small mounds of parakeratosis and a predominantly superficial perivascular and patchy lichenoid inflammatory cell infiltrate consisting of lymphocytes, histiocytes and rare eosinophils that obscures the dermo-epidermal junction in foci where there are occasional necrotic keratinocytes. There are extravasated erythrocytes. There is slight spongosis.

The dermatologist put me on Tetracycline 500 mg 1 2x /day for 4 wks
and then 1 1x/day for another for weeks.
wants to see me in 3 months and then wants to follow up every six months with blood work for lymphoma etc.
Do people usually get Lymphomas with PLC? Can I be assured I don't have lymphoma right now? Anything else I can do? Thank you.
Best Regards.

[sweets1974]

My dermatologist told me I don't have lymphoma. From what you're saying, he probably wants to make sure what I have indeed is a PLC by follow up appointments? Is thislymphoma of the skin? When he says lymphoma is he talking about lymphoma in general or just lymphoma of the skin? He also mentioned that he would check my nodes in my neck as well. If it does turn out to be lymphoma of the skin in future, does this mean it is t cell? I'm just worried right now about 2 issues.
1) when he says lymphoma is he just talking about the skin? or other parts of body
2) could i have lymphoma now but it is not clearly diagnosed due to the similarities of lymphomatoid papules? Is this Cutaneous T cell lymphoma (CTCL) what we are talking about? I had read a lot about this prior to being diagnosed with Pityriasis Rosea initially because my rashes looked very similar to of CTCL. It is pretty bad as it can spread to blood, organs etc. and not be limited to skin only. Should I get a second opinion?
I had a friend with CTCL an older friend and when she had seen me with my first break out in the initial phases with the larger patch etc, and the way I described to her how it all starts and the different phases it goes through especially the larger patches, she kept saying it sounds and looks exactly like what she had but that she hopes its not the same. She also added her diagnosis took about 10 years as CTCL.
Thank you very much for responding.
Best Regards.

[Fernando Roque, MD]

Hi.  Pityriasis Lichenoides Chronica (PLC) has been reported to develop into cutaneous lymphoma in less than 2% of cases.  However, it seems that some of these reports of malignant transformation by PLC are actually misdiagnosed cases of lymphomatoid papules and not PLC.  PLC has some histologic features (characteristics of the tissue when seen under the microscope) which are very similar to that of cutaneous lymphoma so confusion may be made in identifying these two conditions.  Your dermatologist is just making sure that what you actually have is PLC and not lymphoma, hence the need for follow up consults.