title: Multispectral Imaging Approach to the Diagnosis of a CD20+ Cutaneous T-cell Lymphoproliferative Disorder: A Case Report.
abstract: Expression of the pan B-cell marker CD20 by T-cell lymphoproliferative disorders is exceedingly rare. We present a 52-year-old man with a unilesional cutaneous CD20 T-cell lymphoproliferative disorder. Multispectral imaging analysis of CD3-CD20 double-stained lesional tissue sections allowed (1) the visualization of double-positive T lymphocytes in situ with sensitivity superior to that of conventional immunohistochemistry and (2) the quantitative assessment of marker coexpression. Here, 23% of CD3 signals in the patient's lesion were also CD20, whereas 38% of CD20 signals were also CD3. In contrast, both parameters were below 1% in the tonsil control. Overall, the percentage of double-positive cells in lesional skin was 35%, although only 0.4% of such cells were detected in the tonsil. This is the first demonstration of aberrant CD20 expression by skin-infiltrating T cells using multispectral imaging.
authors.affiliation: *Department of Dermatology, University of Wisconsin; and †Department of Dermatology, Northwestern University.
authors.forename: Katrin A
authors.initials: KA
authors.lastname: Salva
authors.forename: Daniel
authors.initials: D
authors.lastname: Bennett
authors.forename: Jack
authors.initials: J
authors.lastname: Longley
authors.forename: Joan
authors.initials: J
authors.lastname: Guitart
authors.forename: Gary S
authors.initials: GS
authors.lastname: Wood
mesh_terms: D018951:Antigens, CD20 / Q000032:analysis*; D057205:Automation, Laboratory; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D017252:CD3 Complex / Q000032:analysis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007150:Immunohistochemistry; D016130:Immunophenotyping / Q000379:methods*; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology* / Q000473:pathology; D016410:Lymphoma, T-Cell, Cutaneous / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012878:Skin Neoplasms / Q000276:immunology* / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology* / Q000473:pathology
chemical_list: D018951:Antigens, CD20; D014408:Biomarkers, Tumor; D017252:CD3 Complex