Abstract
Cutaneous T-cell lymphomas (CTCLs) are rare tumors with no established markers that can reliably distinguish between benign and malignant lesions. Preferentially Expressed Antigen in Melanoma (PRAME) is a cancer/testis antigen that is found in many solid and hematologic malignancies. PRAME overexpression typically portends a poor prognosis and lower chemotherapeutic response. To date, no studies have established a role for PRAME in CTCL. An analysis was performed on 47 cases definitively diagnosed as CTCL: 25 cases of mycosis fungoides, 2 of Sezary syndrome, 5 of CD30+ lymphoproliferative disorder, 7 of primary cutaneous anaplastic large T-cell lymphoma, 3 of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder, 1 of subcutaneous panniculitis-like T-cell lymphoma, and 4 of angiocentric T-cell lymphoma. PRAME immunohistochemistry was completely negative in all cases. PRAME expression was not found in any CTCL subtypes, suggesting that the pathogenesis of CTCL is not mediated by PRAME. Further study is required to identify biomarkers that might aid in the diagnosis and prognostication of CTCLs.
Highlights
Cutaneous T-cell lymphomas (CTCLs) are a rare class of tumors with an annual incidence of approximately 0.5 in 100,000 [1]
The study consisted of 47 CTCLs from patients aged 26 to 91 years with an average age of 59.2, with 31 male (66.0%) and 16 female (34.0%) patients
Preferentially Expressed Antigen in Melanoma (PRAME) immunohistochemical staining was strongly and diffusely positive in both the external positive control—melanoma tissue—and the internal positive control—benign sebaceous glands, whereas the stain was completely negative in all malignant T cells (Table 1, Figure 1)
Summary
Cutaneous T-cell lymphomas (CTCLs) are a rare class of tumors with an annual incidence of approximately 0.5 in 100,000 [1]. While most subtypes of CTCL have an indolent clinical course, there are a number of more aggressive variants that have a very poor prognosis. The diagnosis of MF and other CTCLs can be difficult and requires a combination of the clinical examination, histopathologic evaluation, immunophenotyping, and molecular analysis [3–13]. There are no established molecular markers that can reliably be used to diagnose malignant T cells found in a suspicious skin lesion or to distinguish aggressive from indolent CTCL subtypes. A method that uses immunohistochemistry (IHC) to assist diagnosis and predict prognosis would have great clinical utility, given the superior turnaround time and cost effectiveness with IHC as compared to molecular testing
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