Intraepidermal localization of the clone in cutaneous T-cell lymphoma.
BACKGROUND
No immunohistologic techniques are currently available to demonstrate clonality of T-cell lymphomas. Monoclonal antibodies to the variable region of the T-cell receptor (TCR) have been produced that identify minor populations of normal peripheral blood T lymphocytes.


OBJECTIVE
We investigated the expression of TCR V-region genes in cutaneous lymphomas to determine whether immunostaining with these antibodies may be a simple method to detect clonal T-cell proliferations and help to distinguish benign lymphoid infiltrates from malignant lymphoma.


METHODS
Cutaneous samples were obtained from 18 cutaneous T-cell lymphomas (14 mycosis fungoides, 1 Sézary syndrome, 2 pleomorphic T-cell lymphoma, and 1 large cell anaplastic lymphoma) and 8 benign lymphoid infiltrates. Frozen sections were incubated with monoclonal antibodies and stained by the alkaline phosphatase-antialkaline phosphatase technique. Staining was performed with a panel of 7 anti-TCR V-region antibodies, 6 T-cell markers, 1 anti-beta chain antibody, and 1 anti-delta chain antibody.


RESULTS
Clonality could be demonstrated in 2 of 18 cutaneous lymphomas. We observed the strictly intraepidermal localization of clonal proliferation in one case of early-stage mycosis fungoides.


CONCLUSIONS
Anti-TCR V-region antibodies may identify a strictly epidermotropic clone in early mycosis fungoides. However, the panel of antibodies currently available stains only a minority of cutaneous T-cell lymphomas. The usefulness of these antibodies as a clonotypic marker needs to be reevaluated when a larger panel of antibodies becomes available.
Department of Dermatology, Henri Mondor Hospital, Créteil, France.
M
M
Bagot
J
J
Wechsler
M C
MC
Lescs
J
J
Revuz
J P
JP
Farcet
P
P
Gaulard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D003877:Dermatitis, Contact / Q000473:pathology; D004817:Epidermis / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology; D010267:Parapsoriasis / Q000473:pathology; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000032:analysis*; D012871:Skin Diseases / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D016176:T-Lymphocyte Subsets / Q000473:pathology*; D013602:T-Lymphocytes, Cytotoxic / Q000473:pathology; D050378:T-Lymphocytes, Regulatory / Q000473:pathology
D016693:Receptors, Antigen, T-Cell, alpha-beta