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NCCN Guidelines for Patients


Peripheral T-cell Lymphoma, Version 1.2016


Treatment planning

Prognostic scores

Skin biopsy

Peripheral T-cell lymphomas and other T-cell

lymphomas may involve the skin. Based on your

skin exam, your doctor may want you to have a skin

biopsy. There are multiple types of skin biopsies.

Which one you will have depends on how large

and where the abnormal skin is. Skin samples may

be removed by excisional, incisional, punch, or

shave biopsies. A punch biopsy uses a sharp hollow

device—like a cookie cutter—to remove a small but

deep sample of both skin layers. A shave biopsy

removes the first layer of skin and part of the second


Before the skin biopsy, your skin will be numbed with

local anesthesia. You may feel pressure during the

biopsy, but no pain. Afterward, you doctor may close

the wound and apply a bandage. Often, there are no

side effects, but some people do get scars.

Prognostic scores

A prognosis is a prediction of the pattern and outcome

of a disease. As part of treatment planning, your

doctors will assess the prognosis of the cancer.

There are two methods for predicting the prognosis of

peripheral T-cell lymphoma, which are described next.

Cancer stage

A cancer stage is a rating by your doctors of how

far the cancer has grown and spread. It is used for

prognosis, treatment planning, and to check treatment

results. The Ann Arbor staging system is used to

stage peripheral T-cell lymphoma. In this system,

there are four cancer stages.

Stage I

is cancer that is in only one cluster of

lymph nodes.

Stage II

is cancer that is in 2 or more clusters

either above or below your diaphragm.

Stage III

is cancer that is in lymph tissue on

both sides of your diaphragm.

Stage IV

is cancer that has widely spread

outside the lymphatic system.

When the cancer is staged, other letters are also

assigned. The letters “A” and “B” indicate whether B

symptoms have been present in the past 6 months.

No symptoms is rated A, and if symptoms are present,

B. The letter “E” stands for extranodal disease, which

is cancer in sites other than the lymph nodes. The

letter “X” means the cancer is large (>10 cm).

In general, earlier cancer stages have better

outcomes. However, some people with early-stage

cancer have poor outcomes. Prognosis depends

not just on the cancer stage but other factors. Thus,

doctors have created better methods to predict