Expression of helper T cell master regulators in inflammatory dermatoses and primary cutaneous T-cell lymphomas: Diagnostic implications

Andy C. Hsi, Sena J. Lee, Ilana S. Rosman, Kenneth R. Carson, Amanda Kelley, Valerie Viele, Xiaofan Pang, Amy Musiek, András Schaffer

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Background Mycosis fungoides (MF) is a neoplasm of skin-homing CD4+ helper T (TH) lymphocytes with dysregulation of TH1 and TH2 immunity. Diagnosis of MF is challenging, as there is significant morphologic overlap with other dermatologic entities. Objective We investigated diagnostic utility of TH1- and TH2-specific markers, T-bet, and GATA-3, respectively, in MF and its reactive and neoplastic mimics.

Methods Immunohistochemical staining for CD3/T-bet and CD3/GATA-3 was performed on inflammatory dermatoses (n = 56), MF (n = 37), Sezary syndrome (SS; n = 8), and cutaneous anaplastic large cell lymphoma (C-ALCL; n = 14).

Results Inflammatory dermatoses showed epidermal T cells predominantly expressing GATA-3, except psoriasis, which exhibited a mixed GATA-3/T-bet staining. In contrast, neoplastic T cells in patch stage MF showed markedly increased T-bet positivity with minimal GATA-3 expression. Plaque stage MF had a mixed T-bet/GATA-3 phenotype, whereas tumor stage MF and SS exhibited diffuse GATA-3 expression. C-ALCL lacked significant staining for both markers.

Limitations Sample size was relatively small.

Conclusions A predominance of T-bet+ T cells in the epidermis support patch stage MF over dermatitis. A predominance of GATA-3+ T cells in the dermis support CD30+ MF with large cell transformation over C-ALCL. These stains do not allow distinction between dermatitis and cutaneous infiltrates of SS.

Original languageEnglish
Pages (from-to)159-167
Number of pages9
JournalJournal of the American Academy of Dermatology
Volume72
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • GATA-3
  • Sezary syndrome
  • T helper cell
  • T-bet
  • anaplastic large cell lymphoma
  • cutaneous lymphoma
  • mycosis fungoides

Fingerprint

Dive into the research topics of 'Expression of helper T cell master regulators in inflammatory dermatoses and primary cutaneous T-cell lymphomas: Diagnostic implications'. Together they form a unique fingerprint.

Cite this