Contribution of histopathologic and molecular analyses to the diagnosis of cutaneous B-cell infiltrates

Mod Pathol. 1996 Dec;9(12):1147-55.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • DNA, Neoplasm / analysis
  • Female
  • Gene Rearrangement, B-Lymphocyte, Heavy Chain / genetics
  • Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / genetics
  • Genes, bcl-2 / genetics
  • Genotype
  • Humans
  • Immunoenzyme Techniques
  • Immunoglobulin Heavy Chains / analysis
  • Immunoglobulin Heavy Chains / genetics
  • Lymphoma, B-Cell / diagnosis*
  • Lymphoma, B-Cell / genetics
  • Lymphoma, B-Cell / immunology
  • Male
  • Middle Aged
  • Polymerase Chain Reaction / methods
  • Proto-Oncogene Proteins c-bcl-2 / immunology
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / genetics
  • Skin Neoplasms / immunology

Substances

  • DNA, Neoplasm
  • Immunoglobulin Heavy Chains
  • Proto-Oncogene Proteins c-bcl-2