Immunophenotypic Shifts in Primary Cutaneous gammadelta T-Cell Lymphoma Suggest Antigenic Modulation: A Study of Sequential Biopsy Specimens

Hu, Shimin; Torres-Cabala, Carlos A.; Medeiros, L. Jeffrey; Li, Shaoying; Miranda, Roberto N.; Prieto, Victor G.; Patel, Keyur P.; Merril, Eric D.; Quesada, Andres; Loghavi, Sanam; Tetzlaff, Michael; Duvic, Madeleine; Agbay, Rose Lou Marie C.; Aung, Phyu P.; Young, Ken H.; Ferrufino-Schmidt, Maria C.

dc.contributor.author	Agbay, Rose Lou Marie C.
dc.contributor.author	Torres-Cabala, Carlos A.
dc.contributor.author	Patel, Keyur P.
dc.contributor.author	Merril, Eric D.
dc.contributor.author	Duvic, Madeleine
dc.contributor.author	Quesada, Andres
dc.contributor.author	Prieto, Victor G.
dc.contributor.author	Aung, Phyu P.
dc.contributor.author	Loghavi, Sanam
dc.contributor.author	Young, Ken H.
dc.contributor.author	Hu, Shimin
dc.contributor.author	Ferrufino-Schmidt, Maria C.
dc.contributor.author	Tetzlaff, Michael
dc.contributor.author	Li, Shaoying
dc.contributor.author	Medeiros, L. Jeffrey
dc.contributor.author	Miranda, Roberto N.
dc.date.accessioned	2019-01-25T15:18:37Z
dc.date.available	2019-01-25T15:18:37Z
dc.date.issued	2017
dc.identifier.uri	https://hdl.handle.net/20.500.12866/4676
dc.description.abstract	Primary cutaneous gammadelta T-cell lymphoma (PCGD TCL), an aggressive type of lymphoma, accounts for approximately 1% of all primary cutaneous lymphomas. We have occasionally observed changes in T-cell antigen expression (immunophenotypic [IP] shift) over time, a phenomenon that is considered rare in T-cell lymphoma including cutaneous T-cell lymphoma. Therefore, we assessed sequential biopsies of PCGD TCL for possible IP shifts of the lymphoma cells. We searched for cases of PCGD TCL with consecutive biopsies to perform a comprehensive immunohistochemical analysis of paired specimens. A median of 12 markers per case was tested. We evaluated the percentage of neoplastic lymphocytes and determined the differential expression of antigens (gain, loss, increase or decrease). We identified 9 patients with PCGD TCL with consecutive biopsies. All (100%) cases had IP shifts of at least 1 antigen, whereas overall 22 pairs of markers were shifted: gain of reactivity occurred in 7 (31.8%) and loss in 3 (13.6%); increased reactivity in 4 (18.2%) and decreased in 8 (36.4%). Molecular analysis of TCRgamma showed identically sized monoclonal rearrangements between biopsy pairs in 4/4 (100%) patients. There was no correlation between IP shifts and the clinical appearance of lesions, histopathologic or cytologic features, or molecular rearrangements. IP shifts are common in PCGD TCL, occurring in all patients in this study and involving a variety of antigens. IP shifts do not seem to be linked to changes in the T-cell clone and are without obvious clinical or morphologic correlates. The occurrence of IP shifts in PCGD TCL suggests that antigen modulation may be involved in pathogenesis. IP shifts are somewhat frequent in T-cell lymphoma; however, it does not suggest a second neoplasm, and molecular studies can be used to determine clonal identity.	en_US
dc.language.iso	eng
dc.publisher	Wolters Kluwer Health
dc.relation.ispartofseries	American Journal of Surgical Pathology
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Adult	en_US
dc.subject	Female	en_US
dc.subject	Humans	en_US
dc.subject	Male	en_US
dc.subject	Young Adult	en_US
dc.subject	Aged	en_US
dc.subject	Middle Aged	en_US
dc.subject	Survival Analysis	en_US
dc.subject	Treatment Outcome	en_US
dc.subject	Aged, 80 and over	en_US
dc.subject	Biopsy	en_US
dc.subject	Time Factors	en_US
dc.subject	Child, Preschool	en_US
dc.subject	Polymerase Chain Reaction	en_US
dc.subject	Phenotype	en_US
dc.subject	Immunohistochemistry	en_US
dc.subject	Antigens, Neoplasm/genetics/immunology	en_US
dc.subject	Biomarkers, Tumor/genetics/immunology	en_US
dc.subject	Immunophenotyping/methods	en_US
dc.subject	In Situ Hybridization	en_US
dc.subject	Lymphoma, T-Cell, Cutaneous/genetics/immunology/pathology/therapy	en_US
dc.subject	Receptors, Antigen, T-Cell, gamma-delta/genetics/immunology	en_US
dc.subject	Skin Neoplasms/genetics/immunology/pathology/therapy	en_US
dc.subject	T-Lymphocytes/immunology/pathology	en_US
dc.title	Immunophenotypic Shifts in Primary Cutaneous gammadelta T-Cell Lymphoma Suggest Antigenic Modulation: A Study of Sequential Biopsy Specimens	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1097/PAS.0000000000000786
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.01.09
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.11
dc.relation.issn	1532-0979