Atypical cutaneous lymphocytic infiltrate and a role for quantitative immunohistochemistry and gene rearrangement studies
Aim To help clarify the significance of the T‐cell receptor (TCR) gene rearrangement and its relationship to the immunophenotyping of histologically atypical cutaneous T‐cell lymphoid infiltrates (ACLIs). Materials and methods One hundred and twenty‐four patients presented with lesions clinically su...
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Published in | International journal of dermatology Vol. 38; no. 10; pp. 749 - 756 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Science Ltd
01.10.1999
Blackwell Science Blackwell Publishing Ltd |
Subjects | |
Online Access | Get full text |
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Summary: | Aim To help clarify the significance of the T‐cell receptor (TCR) gene rearrangement and its relationship to the immunophenotyping of histologically atypical cutaneous T‐cell lymphoid infiltrates (ACLIs).
Materials and methods One hundred and twenty‐four patients presented with lesions clinically suspicious for cutaneous T‐cell lymphoma (CTCL). The average age was 55.8 years with a mean follow‐up duration of 26.2 months. Cases were classified as malignant (64 cases), inflammatory dermatosis (28 cases), and indeterminate (32 cases), based on follow‐up data and histopathology. Quantitative immunophenotyping with computer‐assisted imaging was performed using immunohistochemical stains of anti‐CD3, CD4, CD5, CD7, CD8, CD20, CD30, CD56, CD68, Bcl‐2, p53, and proliferating cell nuclear antigen (PCNA).
Results Abnormal immunophenotypic expression in 87.5% of the malignant cases, including CD4 or CD8 predominance (67%), deletion of pan‐T‐cell antigens (16.1%), and activation of antigen/oncogene expression (47%), was observed. In addition, 36 clinically malignant cases displayed rearranged bands by polymerase chain reaction (PCR) with TCR β and γ. Two benign cases displayed abnormal immunophenotype and two others showed rearranged bands. All of these patients responded to topical steroid therapy with complete resolution. Nineteen indeterminate cases displayed either rearranged bands or immunophenotypic abnormalities, 15 of which were reclassified as malignant. All but three patients improved after CTCL treatment.
Conclusion Quantitative immunophenotyping and gene rearrangement analysis can provide detailed information for classifying ACLIs with 91% diagnostic sensitivity and 87% specificity. |
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Bibliography: | istex:6B1321C03347FE52B3B8A920859FC8CDE252F7ED ark:/67375/WNG-47DX2NNK-X ArticleID:IJD809 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0011-9059 1365-4632 |
DOI: | 10.1046/j.1365-4362.1999.00809.x |