Usefulness (or lack thereof) of immunophenotyping in atypical cutaneous T-cell infiltrates.
Our purpose was to evaluate the interobserver concordance for the diagnoses of mycosis fungoides (MF), atypical dermatoses (AD), and benign dermatoses (BD) and the impact of T-cell immunophenotyping on the diagnoses MF, AD, and BD. Specimens of MF (n = 57), AD (n = 27), BD and normal skin (n = 54) were reviewed by 2 hematopathologists and 1 dermatopathologist to establish diagnostic interobserver concordance by routine morphologic examination. Immunophenotyping was performed to evaluate expression of CD2, CD3, CD4, CD5, CD7, CD8, CD20, CD30, and MIB-1. The interobserver concordance was fair to moderate compared with the original diagnosis. Partial deletion of CD2 alone was associated significantly with MF. Epidermal deletions of 2 or 3 T-cell antigens or 2 T-cell antigens not including CD7 were associated significantly with MF. An elevated CD4/CD8 ratio correlated with MF. Morphologic features were most diagnostic of MF. Immunophenotyping generally resulted in downgrading of the reaction pattern but was helpful in distinguishing MF from benign dermatoses.
Florell
Scott R
SR
Department of Dermatology, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA.
Cessna
Melissa
M
Lundell
Ryan B
RB
Boucher
Kenneth M
KM
Bowen
Glen M
GM
Harris
Ronald M
RM
Petersen
Marta J
MJ
Zone
John J
JJ
Tripp
Sheryl
S
Perkins
Sherrie L
SL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D016516:CD4-CD8 Ratio; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D017254:Leukemic Infiltration / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D015588:Observer Variation; D012372:ROC Curve; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism
D015703:Antigens, CD; D014408:Biomarkers, Tumor