BACKGROUND: The diagnosis of mycosis fungoides (MF) is often difficult because of significant clinical and histopathologic overlap with inflammatory dermatoses. T-cell receptor (TCR)gamma chain rearrangement by polymerase chain reaction (PCR) (TCR-PCR) is a helpful adjuvant tool in this setting, but several of the inflammatory dermatoses in the differential diagnosis of MF may contain a clonal T-cell proliferation. OBJECTIVE: We examined whether analysis for T-cell clonality and comparison of the clones with the standardized BIOMED-2 PCR multiplex primers for the TCRgamma chain from two anatomically distinct skin sites improves diagnostic accuracy. METHODS: We examined two biopsy specimens each from 10 patients with unequivocal MF, from 18 patients with inflammatory dermatoses, and from 18 patients who could initially not be definitively given a diagnosis based on clinical and histopathologic criteria. RESULTS: Eight of 10 patients with unequivocal MF had an identical clone in both biopsy specimens. Two of 18 patients with inflammatory dermatoses were found to have a clone in one of the biopsy specimens. On further follow-up of the 18 patients with morphologically nondiagnostic biopsy specimens, 13 of 18 were later confirmed to have MF and 5 of 18 had inflammatory dermatoses. Eleven of 13 patients with MF had an identical clone in both biopsy specimens; two of 13 had a polyclonal amplification pattern in both biopsy specimens. Four of 5 patients with inflammatory dermatoses had no clone in either biopsy specimen. One patient with an inflammatory dermatosis had an identical clone in both specimens. The sensitivity of TCR-PCR analysis to evaluate for an identical clone at different anatomic skin sites (dual TCR-PCR) is 82.6% and the specificity is 95.7%. LIMITATIONS: The number of patients in the study group was limited. CONCLUSION: These data suggest that dual TCR-PCR is a very promising technique with high specificity in distinguishing MF from inflammatory dermatoses.
BACKGROUND: The diagnosis of mycosis fungoides (MF) is often difficult because of significant clinical and histopathologic overlap with inflammatory dermatoses. T-cell receptor (TCR)gamma chain rearrangement by polymerase chain reaction (PCR) (TCR-PCR) is a helpful adjuvant tool in this setting, but several of the inflammatory dermatoses in the differential diagnosis of MF may contain a clonal T-cell proliferation. OBJECTIVE: We examined whether analysis for T-cell clonality and comparison of the clones with the standardized BIOMED-2 PCR multiplex primers for the TCRgamma chain from two anatomically distinct skin sites improves diagnostic accuracy. METHODS: We examined two biopsy specimens each from 10 patients with unequivocal MF, from 18 patients with inflammatory dermatoses, and from 18 patients who could initially not be definitively given a diagnosis based on clinical and histopathologic criteria. RESULTS: Eight of 10 patients with unequivocal MF had an identical clone in both biopsy specimens. Two of 18 patients with inflammatory dermatoses were found to have a clone in one of the biopsy specimens. On further follow-up of the 18 patients with morphologically nondiagnostic biopsy specimens, 13 of 18 were later confirmed to have MF and 5 of 18 had inflammatory dermatoses. Eleven of 13 patients with MF had an identical clone in both biopsy specimens; two of 13 had a polyclonal amplification pattern in both biopsy specimens. Four of 5 patients with inflammatory dermatoses had no clone in either biopsy specimen. One patient with an inflammatory dermatosis had an identical clone in both specimens. The sensitivity of TCR-PCR analysis to evaluate for an identical clone at different anatomic skin sites (dual TCR-PCR) is 82.6% and the specificity is 95.7%. LIMITATIONS: The number of patients in the study group was limited. CONCLUSION: These data suggest that dual TCR-PCR is a very promising technique with high specificity in distinguishing MF from inflammatory dermatoses.
Authors: Bing Zhang; Andrew H Beck; Janis M Taube; Sabine Kohler; Katie Seo; Jeffrey Zwerner; Natalie Viakhereva; Uma Sundram; Youn H Kim; Iris Schrijver; Daniel A Arber; James L Zehnder Journal: J Mol Diagn Date: 2010-03-04 Impact factor: 5.568
Authors: James T Edinger; Beth Z Clark; Brian E Pucevich; Larisa J Geskin; Steven H Swerdlow Journal: Am J Surg Pathol Date: 2009-12 Impact factor: 6.394
Authors: Daniel López Aventín; Fernando Gallardo; Luis Colomo; Ester Moragón; María Carmen Vela; Xavier Duran Jordà; Beatriz Bellosillo; Ramon M Pujol Journal: Acta Derm Venereol Date: 2021-05-19 Impact factor: 3.875
Authors: Andreas Willerslev-Olsen; Thorbjørn Krejsgaard; Lise M Lindahl; Charlotte Menne Bonefeld; Mariusz A Wasik; Sergei B Koralov; Carsten Geisler; Mogens Kilian; Lars Iversen; Anders Woetmann; Niels Odum Journal: Toxins (Basel) Date: 2013-08-14 Impact factor: 4.546