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1.
Oncol Rep ; 45(1): 349-358, 2021 01.
Article in English | MEDLINE | ID: mdl-33416132

ABSTRACT

Cutaneous T­cell lymphoma (CTCL) is difficult to diagnose at an early stage. Current diagnostic tools include clinical examination, histomorphologic analysis, immunohistochemistry, flow cytometry of peripheral blood and/or lesional tissue, and evaluation of T­cell receptor (TCR) clonality by gene rearrangement analysis (TCRGR). Advances in genomic sequencing, including high­throughput sequencing (HTS), can be used to identify specific clones of rearranged TCR genes. Even with all of these tools, CTCL can take as long as a decade to definitively diagnose, potentially delaying treatment options and causing patient anxiety. This study aimed to evaluate the performance of the various ancillary testing modalities used to diagnose early­stage CTCL. In a subset of patients the performance of HTS was compared to flow cytometry and conventional TCRGR analysis via polymerase chain reaction (PCR). Fifty­five patients, with a total of 68 skin biopsies and peripheral blood draws, were evaluated using flow cytometry, PCR­TCRGR, and HTS­TCRGR to determine the sensitivity and specificity of each ancillary test. In tissue biopsies, flow cytometry (64%), PCR (71%) and HTS (69%) shared similar sensitivities; flow cytometry had the highest specificity (93%), followed by HTS (86%) and PCR (76.9%). However, flow cytometry and PCR had insufficient DNA quantities in 29 and 15% of the specimens, respectively. Peripheral blood testing was less sensitive than tissue testing (flow cytometry 14%, PCR 41%, HTS 33%); in peripheral blood, HTS was the most specific test (flow cytometry, 70%; PCR, 62.5%; and HTS, 100%). HTS is a highly specific molecular test for identifying CTCL in peripheral blood and skin biopsy specimens; however, our findings suggest a need for a continued search for more sensitive tests for early­stage CTCL.


Subject(s)
Early Detection of Cancer/methods , Lymphoma, T-Cell, Cutaneous/diagnosis , Skin Neoplasms/diagnosis , Adult , Aged , Aged, 80 and over , Biopsy , Diagnosis, Differential , Feasibility Studies , Female , Flow Cytometry , Gene Rearrangement , High-Throughput Nucleotide Sequencing , Humans , Lymphoma, T-Cell, Cutaneous/blood , Lymphoma, T-Cell, Cutaneous/genetics , Lymphoma, T-Cell, Cutaneous/pathology , Male , Middle Aged , Polymerase Chain Reaction , Sensitivity and Specificity , Skin/pathology , Skin Neoplasms/blood , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Young Adult
2.
Clin Case Rep ; 5(9): 1482-1485, 2017 09.
Article in English | MEDLINE | ID: mdl-28878909

ABSTRACT

Extramedullary plasmacytomas, Epstein-Bar virus (EBV) associated, are rarely encountered and usually have a fairly good clinical outcome. EBV+ plasmacytoma may cause a diagnostic dilemma as it phenotypically resembles an aggressive plasmablastic lymphoma (PBL). Herein, we report a unique case with maxillary EBV+ plasmacytoma from a 76-year-old immunocompetent individual.

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