The Value of PCR Detection of TCR gamma Gene Rearrangement in the Diagnosis of Early Mycosis Fungoides / 대한피부과학회지

ABSTRACT

BACKGROUND: The diagnosis and differential diagnosis of mycosis fungoides(MF) is often difficult, clinically and histologically. A variety of inflammatory dermatoses may be seen with similar clinical and histological features. Given the limitation of histologic diagnosis in the early MF, an ancillary method to demonstrate a clonal T cell proliferation would be helpful. Recent attempts to enhance diagnostic sensitivity have involved T-cell receptor(TCR) gene rearrangement studies, using polymerase chain reaction(PCR) technique. OBJECTIVE: The purpose of this study was the value of PCR detection of TCR gamma gene rearrangement in the diagnosis of early MF. MATERIALS AND METHODS: Thirty-two cases of paraffin embedded tissue(PET) from patients of early MF were investigated for the presence of TCR gamma gene rearrangement using a nested PCR technique and analyzed by polyacrylamide gel electrophoresis(PAGE). As a control, PET from patients of 6 psoriasis, 3 lichen planus, 1 neurodermatitis, and 1 allergic contact dermatitis were tested. RESULTS: Monoclonal TCR gamma gene rearrangement was detected in 28 out of 32 (88%) patients with early MF and in none out of 11 patients with inflammatory skin diseases. CONCLUSION: TCR gamma gene rearrangement studies on lesional skin using PCR may be helpful as an adjunct to the histopathologic diagnosis of early MF.