Assessment of T-cell clonality via T-cell receptor-γ rearrangements in cutaneous T-cell-dominant infiltrates using polymerase chain reaction and single-stranded DNA conformational polymorphism assay

Michael Chen, April Deng, A. Neil Crowson, Mythily Srinivasan, Kurtis H. Yearsley, Scott Jewell, Carl Morrison, Susan Long, Robert Werling, Cynthia Magro

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Discerning the pathologic significance of cutaneous T-cell infiltrates can pose a diagnostic challenge for dermatopathologists. Reactive conditions such as drug-associated lymphomatoid hypersensitivity and lymphomatoid lupus erythematosus can demonstrate lymphoid atypia and a phenotype resembling cutaneous T-cell lymphoma (CTCL). Further, lymphoid dyscrasias such as pityriasis lichenoides chronica, large plaque parapsoriasis, and atypical pigmentary purpura confuse the picture because they not only mimic CTCL but also represent prelymphomatous states with inherent malignant potential. Although the emergence of a dominant clone has been considered a clue indicative of a T-cell dyscrasia, there are reports concerning the identification of monoclonality in biopsies of reactive lymphoid infiltrates. We have conducted a modified single-stranded DNA conformational polymorphism (SSCP) assay using paraffin-embedded, formalin-fixed tissue on 92 T-cell-rich biopsies to determine the relative specificity and sensitivity of this methodology. In addition, laser capture microdissection (LCM) was performed on 22 of the 92 samples to isolate the area of interest and to compare its specificity and sensitivity with those SSCP assays performed without LCM. We found that monoclonality or oligoclonality is 86% specific for preneoplastic and neoplastic states, whereas the finding of polyclonality appears to be relatively specific for a reactive process. Some cases of reversible T-cell dyscrasia produced a molecular profile mimicking lymphoma or prelymphomatous states by virtue of monoclonality or oligoclonality. Although LCM appears to improve the sensitivity for detecting preneoplastic conditions, the relative specificity appears to be the same as that encountered with routine SSCP.

Original languageEnglish (US)
Pages (from-to)373-379
Number of pages7
JournalApplied Immunohistochemistry and Molecular Morphology
Volume12
Issue number4
StatePublished - Dec 2004

Fingerprint

Single-Stranded Conformational Polymorphism
Single-Stranded DNA
T-Cell Antigen Receptor
Laser Capture Microdissection
T-Lymphocytes
Cutaneous T-Cell Lymphoma
Polymerase Chain Reaction
Skin
Pityriasis Lichenoides
Parapsoriasis
Precancerous Conditions
Biopsy
Sensitivity and Specificity
Purpura
Paraffin
Formaldehyde
Lymphoma
Hypersensitivity
Clone Cells
Phenotype

Keywords

  • Cutaneous T-cell-rich infiltrates
  • T-cell clonality

ASJC Scopus subject areas

  • Anatomy
  • Medical Laboratory Technology

Cite this

Assessment of T-cell clonality via T-cell receptor-γ rearrangements in cutaneous T-cell-dominant infiltrates using polymerase chain reaction and single-stranded DNA conformational polymorphism assay. / Chen, Michael; Deng, April; Crowson, A. Neil; Srinivasan, Mythily; Yearsley, Kurtis H.; Jewell, Scott; Morrison, Carl; Long, Susan; Werling, Robert; Magro, Cynthia.

In: Applied Immunohistochemistry and Molecular Morphology, Vol. 12, No. 4, 12.2004, p. 373-379.

Research output: Contribution to journalArticle

Chen, Michael ; Deng, April ; Crowson, A. Neil ; Srinivasan, Mythily ; Yearsley, Kurtis H. ; Jewell, Scott ; Morrison, Carl ; Long, Susan ; Werling, Robert ; Magro, Cynthia. / Assessment of T-cell clonality via T-cell receptor-γ rearrangements in cutaneous T-cell-dominant infiltrates using polymerase chain reaction and single-stranded DNA conformational polymorphism assay. In: Applied Immunohistochemistry and Molecular Morphology. 2004 ; Vol. 12, No. 4. pp. 373-379.
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AU - Deng, April

AU - Crowson, A. Neil

AU - Srinivasan, Mythily

AU - Yearsley, Kurtis H.

AU - Jewell, Scott

AU - Morrison, Carl

AU - Long, Susan

AU - Werling, Robert

AU - Magro, Cynthia

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