A new polymerase chain reaction-based method for the detection of T-cell clonality in patients with possible cutaneous T-cell lymphoma.
OBJECTIVE
To evaluate a new, rapid, and sensitive method for the detection of T-cell clonality in patients with lesions suggestive of cutaneous T-cell lymphoma (CTCL).


METHODS
Skin specimens were obtained from 48 patients with possible CTCL. Polymerase chain reaction amplification of the T-cell receptor gamma (TCRG) gene was performed using consensus primers to the V and J regions. Clonal populations having identical N-region sequences are detected by single-strand conformation polymorphism analysis using a semiautomated electrophoresis system with a silver-staining method for gel visualization. The results of clinicopathological assessment were compared with those of immunohistochemistry and polymerase chain reaction analysis.


METHODS
Cutaneous lymphoma clinic at a university medical center.


METHODS
Forty-eight patients with skin lesions suggestive of CTCL.


RESULTS
Based on the clinicopathological assessment, 26 patients were diagnosed as having CTCL. Of them, clonality was detected in 19 patients (73%) and an abnormal phenotype in 17 (68%) of 25 patients. Combining both tests, abnormal results were noted in 24 (92%) of 26 patients with CTCL. Clonality was also identified in 2 (12%) of 17 patients with presumably benign lesions on clinicopathological assessment.


CONCLUSIONS
Polymerase chain reaction and single-strand conformation polymorphism analysis of the TCRG gene is a rapid and sensitive method that can contribute to the diagnosis of CTCL. The new method is especially useful when used in conjunction with immunophenotyping.
Department of Dermatology, Northwestern University Medical Center, Chicago, Ill, USA.
J
J
Guitart
K
K
Kaul
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002999:Clone Cells; D005260:Female; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology*; D013601:T-Lymphocytes / Q000166:cytology*