scholarly journals Utility of flow cytometry and gene rearrangement analysis in tissue and blood of patients with suspected cutaneous T‑cell lymphoma

2020 ◽  
Vol 45 (1) ◽  
pp. 349-358
Author(s):  
Julie Gibbs ◽  
Sophia Ma ◽  
Anna Kim ◽  
Lucia Seminario‑Vidal ◽  
Lubomir Sokol ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
T Cell ◽  
Gene Rearrangement ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Cutaneous T Cell Lymphoma ◽  
Gene Rearrangement Analysis

scholarly journals T-Cell Receptor-G Gene Rearrangement Analysis in the Diagnosis of Patients with Erythroderma / Dijagnostički Značaj Analize Preuređenja Gena Gama Lanca T-Ćelijskog Receptora Kod Pacijenata Sa Eritrodermijom

2009 ◽  
Vol 1 (1) ◽  
pp. 17-26
Author(s):  
Lidija Kandolf-Sekulović ◽  
Bojana Cikota ◽  
Miroslav Dinić ◽  
Dušan Škiljević ◽  
Zvonko Magić
Keyword(s):  
T Cell ◽  
T Cell Receptor ◽  
Peripheral Blood ◽  
Gene Rearrangement ◽  
Cell Lymphoma ◽  
Cell Receptor ◽  
T Cell Lymphoma ◽  
Cutaneous T Cell Lymphoma ◽  
Inflammatory Dermatosis ◽  
Gene Rearrangement Analysis

Abstract The diagnosis of erythroderma is challenging, since clinical, histopathological and immunophenotypic findings are insufficient to differentiate between inflammatory and lymphomatous erythroderma. Thus, multiplex PCR was used for T-cell receptor-γ gene rearrangement analysis, in the skin and peripheral blood samples of 24 patients (20 men and 4 women) with erythroderma of varying origin, in order to estimate its diagnostic value. Cutaneous T-cell lymphoma was confirmed in 9, benign inflammatory dermatosis in 12, and idiopathic erythroderma and clonal dermatitis in 3 patients. In the group of patients with erythrodermic cutaneous T-cell lymphoma, the dominant clone was detected in the skin of 8/9, and in none of the patients with inflammatory dermatoses. A dominant clone was found in peripheral blood of 5/6 samples of patients with erythrodermic cutaneous T-cell lymphoma, and in 2/12 patients with inflammatory dermatosis. T-cell receptor-γ gene rearrangement analysis is valuable in differentiation between inflammatory and lymphomatous erythroderma, thus substantially improving the diagnosis of patients with erythroderma.

Ehrlichiosis Mimicking T-Cell Lymphoma/Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4343-4343
Author(s):  
Ashok Malani ◽  
Robert Weigand ◽  
Vicram Gupta ◽  
Lawrence Hertzberg ◽  
Gautam Rangineni
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
T Cell ◽  
T Cell Receptor ◽  
Gene Rearrangement ◽  
Bone Marrow Cells ◽  
Cell Lymphoma ◽  
Cell Receptor ◽  
T Cell Lymphoma ◽  
Pcr Analysis

Abstract Immunophenotyping by flow cytometry has revolutinized the diagnosis of blood cell disorders such as leukemias and lymphomas and is now commonly used in diagnosis and prognosis of such patients. We describe a case of human ehrlichiosis mimicking T-cell lymphoma/leukemia based on flow cytometry of bone marrow cells and confirmed by T-cell receptor gene rearrangement (TCR) by polymerase chain reaction (PCR). Treatment with doxycycline reversed these findings. A 20-year-old, Amish female presented with fatigue, fever, chills, sweating, low back pain, and lower abdominal pain for 2 days. She admitted to multiple bites from ticks 2 weeks prior to presentation and also reported having numerous animals such as cats, dogs, cows, goats, horses at her farm where she lived. Clinical exam was significant for fever of 101.4 F, heart rate of 118/min, BP of 80/60 mm Hg and a distended urinary bladder which was treated by catheter drainage. Relevant laboratory tests are shown in table 1. Table 1 Hemoglobin 9.7 12–16 gm/dl WBC 0.8 4–10.8 k/mm3 Platelets 16 150–400 k/mm3 Segments 62% 50–75% Lymphocytes 15% 20–40% Sodium 140 125–135 mmol/L AST 126 0–37 IU/L ALT 71 0–65 IU/L Alk. Phos. 49 50–136 IU/L LDH 691 91–190 IU/L Chest radiograph, Ultrasound and Computed tomography scan of the abdomen were within normal limits. With a provisional diagnosis of septic shock and suspicion for Ehrlichiosis, therapy with intravenous(IV) fluids, vasopressors and doxycycline was initiated. Blood was cultured and a sample was forwarded to CDC for analysis of tick borne infections. In order to evaluate and exclude blood disorders like leukemia and lymphoma in a patient with fever and pancytopenia, a bone marrow aspiration and biopsy was performed. It showed cytologically abnormal-appearing, large sized lymphocyte population with irregular nuclear membranes. Flow cytometry of the bone marrow cells revealed 8–10% of phenotypically abnormal T-cells with abnormally weak intensity of membrane surface CD3, CD5, and CD7 expression and negativeCD4 and CD8 expression. These cells also expressed HLA-DR and CD38 at uncommonly bright intensity and there were no CD34 benign immature B-cells. Cytogenetics however was normal. Interestingly, PCR analysis was positive for clonal TCR gamma gene rearrangement. These results were reported as consistent with involvement of marrow by a peripheral T-cell lymphoma/leukemia T-Cell receptor PCR analysis T-Cell receptor PCR analysis Since the patient was steadily improving with IV Doxycycline, we decided to wait and repeated the bone marrow aspiration a week later. This time the bone marrow exam was found to be normal morphologically, on flow cytometry and TCR gamma gene rearrangement by PCR. Patient was discharged on oral doxycycline after a stay of 13 days in the hospital. The blood test for ehrlichiosis from CDC was reported 3 weeks later as positive for Ehrlichia chaffeensis by PCR. Patient is doing well 6 months after the illness. This case illustrates that Ehrlichiosis can transiently cause T cell abnormalities resulting in false positive analysis on flow cytometry and TCR gamma gene rearrangement, thereby leading to false positive diagnosis of Ehrlichiosis. Reconfirmation with repeat studies need to be done before considering active treatment for lymphoma/leukemia.

Cutaneous T-cell lymphoma severity index and T-cell gene rearrangement

The Lancet ◽  
1997 ◽  
Vol 350 (9093) ◽  
pp. 1776-1777 ◽  
Author(s):  
E Dippel ◽  
S Goerdt ◽  
C Assaf ◽  
H Stein ◽  
CE Orfanos
Keyword(s):  
T Cell ◽  
Gene Rearrangement ◽  
Cell Lymphoma ◽  
Severity Index ◽  
T Cell Lymphoma ◽  
Cutaneous T Cell Lymphoma ◽  
Cell Gene

scholarly journals Early diagnosis of cutaneous T-cell lymphoma by DNA flow cytometry on skin biopsies

Cancer ◽  
1984 ◽  
Vol 54 (7) ◽  
pp. 1348-1352 ◽  
Author(s):  
Gunhild Lange Wantzin ◽  
JøRgen K. Larsen ◽  
Ib J. Christensen ◽  
Elisabeth Ralfkiær ◽  
Kristian Thomsen
Keyword(s):  
Flow Cytometry ◽  
T Cell ◽  
Early Diagnosis ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Dna Flow Cytometry ◽  
Cutaneous T Cell Lymphoma ◽  
Skin Biopsies
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