title: Contribution of histopathologic and molecular analyses to the diagnosis of cutaneous B-cell infiltrates.
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.
authors.affiliation: Department of Pathology and Histology, Centre Hospitalo-Universitaire de Bordeaux, Université de Bordeaux II, France.
authors.forename: P
authors.initials: P
authors.lastname: Dubus
authors.forename: B
authors.initials: B
authors.lastname: Vergier
authors.forename: M
authors.initials: M
authors.lastname: Beylot-Barry
authors.forename: M M
authors.initials: MM
authors.lastname: Delaunay
authors.forename: J F
authors.initials: JF
authors.lastname: Goussot
authors.forename: C
authors.initials: C
authors.lastname: Beylot
authors.forename: A
authors.initials: A
authors.lastname: de Mascarel
authors.forename: J P
authors.initials: JP
authors.lastname: Farcet
authors.forename: J P
authors.initials: JP
authors.lastname: Merlio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain / Q000235:genetics; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / Q000235:genetics; D019254:Genes, bcl-2 / Q000235:genetics; D005838:Genotype; D006801:Humans; D007124:Immunoenzyme Techniques; D007143:Immunoglobulin Heavy Chains / Q000032:analysis / Q000235:genetics; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000276:immunology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology
chemical_list: D004273:DNA, Neoplasm; D007143:Immunoglobulin Heavy Chains; D019253:Proto-Oncogene Proteins c-bcl-2