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Usefulness (or Lack Thereof) of Immunophenotyping in Atypical Cutaneous T-Cell Infiltrates

Scott R. Florell MD, Melissa Cessna MD, Ryan B. Lundell MD, Kenneth M. Boucher PhD, Glen M. Bowen MD, Ronald M. Harris MD, Marta J. Petersen MD, John J. Zone MD, Sheryl Tripp MT, Sherrie L. Perkins MD, PhD
DOI: http://dx.doi.org/10.1309/3JK2H6Y988NUAY37 727-736 First published online: 1 May 2006


Our purpose was to evaluate the interobserver concordance for the diagnoses of mycosis fungoides (MF), atypical dermatoses (AD), and benign dermatoses (BD) and the impact of T-cell immunophenotyping on the diagnoses MF, AD, and BD. Specimens of MF (n = 57), AD (n = 27), and BD and normal skin (n = 54) were reviewed by 2 hematopathologists and 1 dermatopathologist to establish diagnostic interobserver concordance by routine morphologic examination. Immunophenotyping was performed to evaluate expression of CD2, CD3, CD4, CD5, CD7, CD8, CD20, CD30, and MIB-1.

The interobserver concordance was fair to moderate compared with the original diagnosis. Partial deletion of CD2 alone was associated significantly with MF. Epidermal deletions of 2 or 3 T-cell antigens or 2 T-cell antigens not including CD7 were associated significantly with MF. An elevated CD4/CD8 ratio correlated with MF. Morphologic features were most diagnostic of MF. Immunophenotyping generally resulted in downgrading of the reaction pattern but was helpful in distinguishing MF from benign dermatoses.

Key Words:
  • Cutaneous T-cell lymphoma
  • CTCL
  • Mycosis fungoides
  • MF