Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis
Background/Aims: T-cell acute lymphoblastic leukemia (T-ALL) is an uncommon, aggressive malignancy that rarely presents in the skin and is generally not considered as part of the differential diagnosis by dermatologists and dermatopathologists. We describe an unusual case of T-ALL presenting with fo...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-09-01
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| Series: | Dermatopathology |
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| Online Access: | https://www.karger.com/Article/FullText/501581 |
| _version_ | 1818595827167264768 |
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| author | Joshua J. Clark Jason E. Hawkes Scott R. Florell Rodney R. Miles David A. Wada |
| author_facet | Joshua J. Clark Jason E. Hawkes Scott R. Florell Rodney R. Miles David A. Wada |
| author_sort | Joshua J. Clark |
| collection | DOAJ |
| description | Background/Aims: T-cell acute lymphoblastic leukemia (T-ALL) is an uncommon, aggressive malignancy that rarely presents in the skin and is generally not considered as part of the differential diagnosis by dermatologists and dermatopathologists. We describe an unusual case of T-ALL presenting with folliculocentric, erythematous papules on the face, histologically resembling mycosis fungoides (MF). Immunostaining for terminal deoxynucleotidyl transferase (TdT) was positive in tumor cells, supporting the diagnosis of cutaneous involvement by T-ALL. TdT is a nuclear enzyme expressed by immature lymphoid malignancies, but the expression pattern of this marker is not well characterized in the skin. We aimed to assess TdT staining in skin biopsies with similar-appearing lymphocytic infiltrates. Methods: We evaluated the immunostaining profile of TdT in a cohort of 23 patients, including 13 cases of MF and 10 cases of spongiotic dermatitis. Results: The lymphocytes in the MF and spongiotic dermatitis cases lacked nuclear staining for TdT. Nonspecific, granular, cytoplasmic staining was observed in a small number of background cells. Conclusions: TdT may assist dermatopathologists in discriminating malignant infiltrates of T-ALL from other conditions. |
| first_indexed | 2024-12-16T11:22:12Z |
| format | Article |
| id | doaj.art-d0ddb68374754a5e804671b3e6cb645e |
| institution | Directory Open Access Journal |
| issn | 2296-3529 |
| language | English |
| last_indexed | 2024-12-16T11:22:12Z |
| publishDate | 2019-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Dermatopathology |
| spelling | doaj.art-d0ddb68374754a5e804671b3e6cb645e2022-12-21T22:33:27ZengMDPI AGDermatopathology2296-35292019-09-016318218810.1159/000501581501581Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic DermatitisJoshua J. ClarkJason E. HawkesScott R. FlorellRodney R. MilesDavid A. WadaBackground/Aims: T-cell acute lymphoblastic leukemia (T-ALL) is an uncommon, aggressive malignancy that rarely presents in the skin and is generally not considered as part of the differential diagnosis by dermatologists and dermatopathologists. We describe an unusual case of T-ALL presenting with folliculocentric, erythematous papules on the face, histologically resembling mycosis fungoides (MF). Immunostaining for terminal deoxynucleotidyl transferase (TdT) was positive in tumor cells, supporting the diagnosis of cutaneous involvement by T-ALL. TdT is a nuclear enzyme expressed by immature lymphoid malignancies, but the expression pattern of this marker is not well characterized in the skin. We aimed to assess TdT staining in skin biopsies with similar-appearing lymphocytic infiltrates. Methods: We evaluated the immunostaining profile of TdT in a cohort of 23 patients, including 13 cases of MF and 10 cases of spongiotic dermatitis. Results: The lymphocytes in the MF and spongiotic dermatitis cases lacked nuclear staining for TdT. Nonspecific, granular, cytoplasmic staining was observed in a small number of background cells. Conclusions: TdT may assist dermatopathologists in discriminating malignant infiltrates of T-ALL from other conditions.https://www.karger.com/Article/FullText/501581Leukemia cutisT-cell acute lymphoblastic leukemiaTerminal deoxynucleotidyl transferaseImmunohistochemistry |
| spellingShingle | Joshua J. Clark Jason E. Hawkes Scott R. Florell Rodney R. Miles David A. Wada Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis Dermatopathology Leukemia cutis T-cell acute lymphoblastic leukemia Terminal deoxynucleotidyl transferase Immunohistochemistry |
| title | Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis |
| title_full | Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis |
| title_fullStr | Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis |
| title_full_unstemmed | Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis |
| title_short | Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis |
| title_sort | cutaneous t cell acute lymphoblastic leukemia and the expression pattern of terminal deoxynucleotidyl transferase immunostaining in mycosis fungoides and spongiotic dermatitis |
| topic | Leukemia cutis T-cell acute lymphoblastic leukemia Terminal deoxynucleotidyl transferase Immunohistochemistry |
| url | https://www.karger.com/Article/FullText/501581 |
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