Article : Potential Diagnostic Tools in the Diagnosis of Sézary Syndrome

Angelica Selim, MD reviewing Boonk SE et al. J Cutan Pathol 2015 Sep.


Thymocyte selection–associated high-mobility group box protein is promising as a marker for Sézary Syndrome

Sézary syndrome (SS), a cutaneous T-cell lymphoma, involves clonal expansion of neoplastic T cells of skin and peripheral blood. These authors examined the use of two biomarkers — thymocyte selection–associated high-mobility group box protein (TOX) and C-MYC — for differentiating SS from erythrodermic dermatitis.

The authors studied 15 SS and 17 erythrodermic dermatitis biopsies. Strong nuclear staining for TOX in more than 50% of skin-infiltrating T cells was seen in 87% of the SS cases. Strong nuclear staining did not appear in erythrodermic dermatitis cases, but weak nuclear staining appeared in 11% to 50% of T cells in these samples. C-MYC had similar staining patterns in SS and erythrodermic dermatitis. Epidermotropism was seen in 66% of SS cases; half showed Pautrier microabscesses. The infiltrate was predominantly CD4+ T cells. In 17% of the erythrodermic dermatitis samples, the cytologic atypia of the lymphocytes suggested a lymphoproliferative disorder. No patients developed lymphoma over a median follow-up of 3.8 years


Citation(s):

Boonk SE et al. Differential expression of TOX by skin-infiltrating T cells in Sézary syndrome and erythrodermic dermatitis. J Cutan Pathol 2015 Sep; 42:604.

 

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