Immunophenotypic and genotypic analysis in cutaneous lymphoid hyperplasias.
BACKGROUND
The clinical utility of immunophenotyping and Southern blot analysis in the evaluation of patients with cutaneous lymphoid hyperplasia (CLH) is controversial.


OBJECTIVE
Our purpose was to determine whether adjunctive immunophenotyping and Southern blot analysis are of diagnostic and prognostic value in patients with CLH.


METHODS
Immunophenotyping was performed on skin biopsy specimens from 26 patients with a routine histologic diagnosis of CLH. Southern blot analysis for immunoglobulin (Ig) gene rearrangements was done on 13 of 26 cases.


RESULTS
Twenty-four of 26 patients had polyclonal CLH on immunophenotyping: 2 of 26 had monoclonal lymphoma. Two of 11 patients with polyclonal CLH studied by Southern blot analysis had clonal Ig gene rearrangements. In both, lymphoma developed within 1 to 6 years; comparison of CLH and malignant lymphoma demonstrated overlapping and different clonal bands. Two additional patients with polyclonal CLH developed lymphoma. No clonal gene rearrangements were detected in the CLH or lymphoma from one; the other was not studied.


CONCLUSIONS
Immunophenotyping will identify some patients with lymphoma with nondiagnostic histologic features. Southern blot analysis will predict some patients with polyclonal CLH in whom malignant lymphoma will develop and who may benefit from definitive therapy.
Hammer
E
E
Department of Pathology, Oregon Health Sciences University 97201.
Sangueza
O
O
Suwanjindar
P
P
White
C R
CR
Braziel
R M
RM
D000328:Adult; D000368:Aged; D015139:Blotting, Southern; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin; D005838:Genotype; D006801:Humans; D006965:Hyperplasia; D016130:Immunophenotyping; D008214:Lymphocytes / Q000276:immunology*; D008223:Lymphoma / Q000235:genetics / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D012871:Skin Diseases / Q000235:genetics* / Q000276:immunology* / Q000473:pathology; D012878:Skin Neoplasms / Q000235:genetics / Q000276:immunology / Q000473:pathology