T cell receptor gamma-chain gene polymerase chain reaction to diagnose central nervous system involvement by cutaneous T cell lymphoma.
The authors describe a patient who was suspected of having cutaneous T cell lymphoma involvement of the brain despite repeatedly negative cerebrospinal fluid (CSF) cytology, inconclusive flow cytometry, and no discrete lesion for brain biopsy. The diagnosis was made by polymerase chain reaction (PCR) analysis that showed a monoclonal T cell receptor gamma-chain gene rearrangement in the CSF, identically sized to that present in a skin biopsy specimen. Thus, PCR could be used early and routinely to diagnose central nervous system spread of T cell lymphomas, because of its potentially superior sensitivity and specificity to CSF cytology.
Taylor
Robert
R
Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. rat@mail.med.upenn.edu
Vergilio
Jo-Anne
JA
Shapiro
Michael
M
Raizen
David
D
Hunt
Jennifer
J
McGrath
Cindy
C
Rook
Alain
A
Bagg
Adam
A
D000368:Aged; D001706:Biopsy; D001932:Brain Neoplasms / Q000235:genetics*; D003584:Cytological Techniques; D005260:Female; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / Q000235:genetics*; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000235:genetics*; D016133:Polymerase Chain Reaction; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000134:cerebrospinal fluid / Q000235:genetics*