Expression of helper T cell master regulators in inflammatory dermatoses and primary cutaneous T-cell lymphomas: Diagnostic implications - 13/12/14
Abstract |
Background |
Mycosis fungoides (MF) is a neoplasm of skin-homing CD4+ helper T (TH) lymphocytes with dysregulation of TH1 and TH2 immunity. Diagnosis of MF is challenging, as there is significant morphologic overlap with other dermatologic entities.
Objective |
We investigated diagnostic utility of TH1- and TH2-specific markers, T-bet, and GATA-3, respectively, in MF and its reactive and neoplastic mimics.
Methods |
Immunohistochemical staining for CD3/T-bet and CD3/GATA-3 was performed on inflammatory dermatoses (n = 56), MF (n = 37), Sezary syndrome (SS; n = 8), and cutaneous anaplastic large cell lymphoma (C-ALCL; n = 14).
Results |
Inflammatory dermatoses showed epidermal T cells predominantly expressing GATA-3, except psoriasis, which exhibited a mixed GATA-3/T-bet staining. In contrast, neoplastic T cells in patch stage MF showed markedly increased T-bet positivity with minimal GATA-3 expression. Plaque stage MF had a mixed T-bet/GATA-3 phenotype, whereas tumor stage MF and SS exhibited diffuse GATA-3 expression. C-ALCL lacked significant staining for both markers.
Limitations |
Sample size was relatively small.
Conclusions |
A predominance of T-bet+ T cells in the epidermis support patch stage MF over dermatitis. A predominance of GATA-3+ T cells in the dermis support CD30+ MF with large cell transformation over C-ALCL. These stains do not allow distinction between dermatitis and cutaneous infiltrates of SS.
Le texte complet de cet article est disponible en PDF.Key words : T-bet, GATA-3, cutaneous lymphoma, mycosis fungoides, Sezary syndrome, anaplastic large cell lymphoma, T helper cell
Abbreviations used : ALK, CTCL, C-ALCL, H&E, IFN, IL, LCT, MF, Non-PSO, PSO, SS, TCR, TH, Treg
Plan
| Supported by Washington University in St. Louis, Department of Pathology and Immunology Research Grant Program. |
|
| Conflicts of interest: None declared. |
Vol 72 - N° 1
P. 159-167 - janvier 2015 Retour au numéro
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