1. Contribution of histopathologic and molecular analyses to the diagnosis of cutaneous B-cell infiltrates.
- Author
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Dubus P, Vergier B, Beylot-Barry M, Delaunay MM, Goussot JF, Beylot C, de Mascarel A, Farcet JP, and Merlio JP
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, DNA, Neoplasm analysis, Female, Gene Rearrangement, B-Lymphocyte, Heavy Chain genetics, Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor genetics, Genes, bcl-2 genetics, Genotype, Humans, Immunoenzyme Techniques, Immunoglobulin Heavy Chains analysis, Immunoglobulin Heavy Chains genetics, Lymphoma, B-Cell genetics, Lymphoma, B-Cell immunology, Male, Middle Aged, Polymerase Chain Reaction methods, Proto-Oncogene Proteins c-bcl-2 immunology, Skin Neoplasms genetics, Skin Neoplasms immunology, Lymphoma, B-Cell diagnosis, Skin Neoplasms diagnosis
- Abstract
To evaluate the value of morphologic, immunohistochemical and molecular analyses, we studied 21 skin biopsy specimens from 19 patients with primary cutaneous B-cell infiltrates. Morphologic review by two independent dermatopathologists confirmed the consensus diagnoses of lymphoma (n = 6) or benign lymphoid hyperplasia (n = 6). A discordant diagnosis was made for the other samples (n = 9), which were thereafter considered as unclassified lymphoid infiltrates. Immunohistochemical analysis showed either a monotypic expression of immunoglobulin light chain or a positive staining with anti-bcl-2 antibodies in three and four samples, respectively, of lymphoma. Polymerase chain reaction was used to analyze immunoglobulin heavy chain and T-cell receptor gamma chain gene rearrangement and to amplify t(14;18) and t(11;14) break points. A clonal molecular marker was detected in 12 of 19 patients. Among these 12 patients, a final diagnosis of lymphoma was confirmed in 8 patients, including the 6 with a morphologic diagnosis of lymphoma. Two patients with clonal benign lymphoid hyperplasia and two with clonal unclassified lymphoid infiltrate presented a benign clinical outcome; one patient was lost to follow-up. Alternatively, no clonal molecular marker was found in two of the patients with lymphoma. The morphologic and molecular criteria, therefore, provided complementary and partially overlapping information for the diagnosis of cutaneous B-cell infiltrates. We proposed a practical use for these data.
- Published
- 1996