Diagnosis of cutaneous T-cell lymphoma detecting T-cell receptor gamma chain gene monoclonality by denaturing gradient gel electrophoresis

Acta Clin Belg. 1999 Apr;54(2):65-71.

Abstract

Cutaneous T-cell lymphomas represent a group of malignant lymphoproliferative disorders characterised by the occurrence of a monoclonal population of T-lymphocytes. Diagnosis of early stages of this disease is a difficult challenge for both the dermatologist and the dermatopathologist. With the aid of the polymerase chain reaction it is possible to amplify specific regions of the T-cell receptor gamma gene. The amplification products can then be separated by denaturing gradient gel electrophoresis in order to detect a monoclonal population of T-lymphocytes in the infiltrate. We studied 4 patients with the clinicopathologic diagnosis of mycosis fungoides and 2 patients diagnosed as large plaque parapsoriasis. A monoclonal population was detected in 3 of the 4 mycosis fungoides cases and in 1 of the patients with large plaque parapsoriasis. This indicates that our analysis can help us establishing a diagnosis, and it can also help us to identify patients with a possible early stage of the disease, which clinically or histologically is not yet recognised as such.

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Electrophoresis, Agar Gel
  • Gene Amplification
  • Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / genetics
  • Genes, T-Cell Receptor gamma / genetics*
  • Humans
  • Lymphoma, T-Cell, Cutaneous / diagnosis*
  • Lymphoma, T-Cell, Cutaneous / genetics
  • Lymphoma, T-Cell, Cutaneous / pathology
  • Middle Aged
  • Mycosis Fungoides / diagnosis
  • Mycosis Fungoides / genetics
  • Mycosis Fungoides / pathology
  • Parapsoriasis / diagnosis
  • Parapsoriasis / genetics
  • Parapsoriasis / pathology
  • Polymerase Chain Reaction
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / genetics
  • Skin Neoplasms / pathology
  • T-Lymphocytes / pathology