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- Title
TOX expression in cutaneous T-cell lymphomas: an adjunctive diagnostic marker that is not tumour specific and not restricted to the CD4<sup>+</sup> CD8<sup>−</sup> phenotype.
- Authors
Schrader, A.M.R.; Jansen, P.M.; Willemze, R.
- Abstract
Background TOX (thymocyte selection-associated high-mobility group box) was shown to be aberrantly expressed in mycosis fungoides ( MF) and Sézary syndrome ( SS) and is suggested to have additional diagnostic value. However, data on expression in other types of cutaneous T-cell lymphoma ( CTCL) are scarce and it is unknown whether TOX is expressed only by MF with a CD4+ CD8− phenotype. Objectives To investigate TOX expression in various types of CTCL with different T-cell phenotypes. Methods Immunohistochemical expression of TOX was evaluated on 153 skin biopsies of 132 patients with CTCL and 60 patients with benign inflammatory dermatoses ( BIDs). Results TOX was expressed by > 50% of the neoplastic T cells in 49 of 59 patients (83%) with MF and in 19 of 22 patients (86%) with SS. The TOX+ cases of MF included 34 of 35 cases (97%) with a CD4+ CD8− phenotype, but also five of eight cases (63%) with a CD4− CD8+ phenotype and 10 of 16 cases (63%) with a CD4− CD8− phenotype. TOX expression in other types of CTCL was common but showed variable intensity. Although only one of 60 patients (2%) with a BID expressed TOX in > 50% of the skin-infiltrating T cells, some caution is warranted, as the majority of BIDs had TOX+ T cells varying between 11% and 50%. Conclusions TOX expression is not tumour specific, is not restricted to CTCL with a CD4+ CD8− phenotype, and, on its own, is insufficient for diagnosis of CTCL. However, it may have an adjunctive diagnostic role in conjunction with other clinical and histological data.
- Subjects
T cells; LYMPHOMAS; GENOTYPES; GENETIC pleiotropy; SCURFIN (Protein)
- Publication
British Journal of Dermatology, 2016, Vol 175, Issue 2, p382
- ISSN
0007-0963
- Publication type
Article
- DOI
10.1111/bjd.14508