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The applicability of T-cell receptor gamma gene rearrangement as an adjuvant diagnostic tool in skin biopsies for cutaneous T-cell lymphoma.
Saudi Med J. 2006 Jul; 27(7):951-4.SM

Abstract

OBJECTIVE

The diagnosis of cutaneous T-cell lymphoid infiltrates may be difficult based on clinical and routine immunohistologic findings. In this situation, an ancillary technique demonstrating the presence of a monoclonal cell proliferation could help to rule in or out cutaneous T-cell lymphoma (CTCL) in cases that clinically and histopathologically do not allow a definitive diagnosis. Southern blot analysis is a time-consuming method with low sensitivity that should not be considered for the routine diagnosis of cutaneous lymphoid infiltrates. Moreover, it can be used only when fresh tissue is available. New assays based on the amplification of the T-cell receptor gamma (TCR gamma) chain gene rearrangement by polymerase chain reaction (PCR) have been proposed to overcome these limitations.

METHODS

We retrospectively studied 124 biopsies from 104 patients (66 biopsies with the clinical and histological diagnosis or suspicious of CTCL and 58 biopsies with histological diagnosis of benign reactive dermatological conditions who presented to the Dermatology Unit at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia between 1996 and 2004. The specimens were morphologically examined and then analyzed by PCR for the gamma chain of the TCR gamma followed by gel electrophoresis.

RESULTS

The results showed 87.1% sensitivity and 92% specificity in detecting clonal T-cell gene rearrangements among CTCL cases with a positive predictive value of 93.1% and negative predictive value of 85.2%. Therefore, negative TCR gamma results in CTCL should be taken with caution.

CONCLUSION

The detection of clonal TCR gamma gene rearrangement by PCR based method is an adjuvant diagnostic marker for CTCL, although it can be seen in some benign dermatoses.

Authors+Show Affiliations

Department of Pathology and Laboratory Medicine (MBC-10), King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia. khalil@kfshrc.edu.saNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16830010

Citation

Khalil, Salem H., and Issam R. Hamadah. "The Applicability of T-cell Receptor Gamma Gene Rearrangement as an Adjuvant Diagnostic Tool in Skin Biopsies for Cutaneous T-cell Lymphoma." Saudi Medical Journal, vol. 27, no. 7, 2006, pp. 951-4.
Khalil SH, Hamadah IR. The applicability of T-cell receptor gamma gene rearrangement as an adjuvant diagnostic tool in skin biopsies for cutaneous T-cell lymphoma. Saudi Med J. 2006;27(7):951-4.
Khalil, S. H., & Hamadah, I. R. (2006). The applicability of T-cell receptor gamma gene rearrangement as an adjuvant diagnostic tool in skin biopsies for cutaneous T-cell lymphoma. Saudi Medical Journal, 27(7), 951-4.
Khalil SH, Hamadah IR. The Applicability of T-cell Receptor Gamma Gene Rearrangement as an Adjuvant Diagnostic Tool in Skin Biopsies for Cutaneous T-cell Lymphoma. Saudi Med J. 2006;27(7):951-4. PubMed PMID: 16830010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The applicability of T-cell receptor gamma gene rearrangement as an adjuvant diagnostic tool in skin biopsies for cutaneous T-cell lymphoma. AU - Khalil,Salem H, AU - Hamadah,Issam R, PY - 2006/7/11/pubmed PY - 2007/5/18/medline PY - 2006/7/11/entrez SP - 951 EP - 4 JF - Saudi medical journal JO - Saudi Med J VL - 27 IS - 7 N2 - OBJECTIVE: The diagnosis of cutaneous T-cell lymphoid infiltrates may be difficult based on clinical and routine immunohistologic findings. In this situation, an ancillary technique demonstrating the presence of a monoclonal cell proliferation could help to rule in or out cutaneous T-cell lymphoma (CTCL) in cases that clinically and histopathologically do not allow a definitive diagnosis. Southern blot analysis is a time-consuming method with low sensitivity that should not be considered for the routine diagnosis of cutaneous lymphoid infiltrates. Moreover, it can be used only when fresh tissue is available. New assays based on the amplification of the T-cell receptor gamma (TCR gamma) chain gene rearrangement by polymerase chain reaction (PCR) have been proposed to overcome these limitations. METHODS: We retrospectively studied 124 biopsies from 104 patients (66 biopsies with the clinical and histological diagnosis or suspicious of CTCL and 58 biopsies with histological diagnosis of benign reactive dermatological conditions who presented to the Dermatology Unit at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia between 1996 and 2004. The specimens were morphologically examined and then analyzed by PCR for the gamma chain of the TCR gamma followed by gel electrophoresis. RESULTS: The results showed 87.1% sensitivity and 92% specificity in detecting clonal T-cell gene rearrangements among CTCL cases with a positive predictive value of 93.1% and negative predictive value of 85.2%. Therefore, negative TCR gamma results in CTCL should be taken with caution. CONCLUSION: The detection of clonal TCR gamma gene rearrangement by PCR based method is an adjuvant diagnostic marker for CTCL, although it can be seen in some benign dermatoses. SN - 0379-5284 UR - https://www.unboundmedicine.com/medline/citation/16830010/The_applicability_of_T_cell_receptor_gamma_gene_rearrangement_as_an_adjuvant_diagnostic_tool_in_skin_biopsies_for_cutaneous_T_cell_lymphoma_ L2 - http://www.diseaseinfosearch.org/result/2048 DB - PRIME DP - Unbound Medicine ER -