ISCL/EORTC recommendations for staging evaluation in cutaneous lymphomas other than MF/SS
| Complete history/review of systems and physical examination |
| Laboratory studies |
| Complete blood count, comprehensive serum chemistries, serum LDH |
| Whenever indicated, relevant flow cytometric studies of peripheral blood mononuclear cells |
| Imaging studies* |
| CT of chest, abdomen and pelvis with contrast alone or with whole-body PET (18F-FDG); include CT or ultrasound of neck if clinically indicated |
| Whole-body integrated PET/CT (as alternative imaging study to the standard contrast-enhanced CT) |
| Bone marrow biopsy and aspirate† |
| Required in cutaneous lymphomas with intermediate to aggressive clinical behavior as categorized in the WHO-EORTC classification |
| Should be considered in cutaneous lymphomas with indolent clinical behavior, but not required unless indicated by other staging assessments |
| Additional studies as indicated clinically |
| Complete history/review of systems and physical examination |
| Laboratory studies |
| Complete blood count, comprehensive serum chemistries, serum LDH |
| Whenever indicated, relevant flow cytometric studies of peripheral blood mononuclear cells |
| Imaging studies* |
| CT of chest, abdomen and pelvis with contrast alone or with whole-body PET (18F-FDG); include CT or ultrasound of neck if clinically indicated |
| Whole-body integrated PET/CT (as alternative imaging study to the standard contrast-enhanced CT) |
| Bone marrow biopsy and aspirate† |
| Required in cutaneous lymphomas with intermediate to aggressive clinical behavior as categorized in the WHO-EORTC classification |
| Should be considered in cutaneous lymphomas with indolent clinical behavior, but not required unless indicated by other staging assessments |
| Additional studies as indicated clinically |
Lymph nodes that are >1.0 cm in short axis and/or have significantly increased PET activity should be sampled for tissue examination (an excisional biopsy is preferable whenever possible).
At the time of this proposal, there is not a unified standard for bone marrow examination as part of the staging evaluation in cutaneous lymphomas with indolent clinical behavior. The clinician should follow the standard of care of his or her regional practice.