Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1993 Feb;46(2):129–134. doi: 10.1136/jcp.46.2.129

Combined proliferating cell nuclear antigen and morphometric analysis in the diagnosis of cutaneous lymphoid infiltrates.

A M Clarke 1, W A Reid 1, A S Jack 1
PMCID: PMC501143  PMID: 8096225

Abstract

AIMS: To evaluate the use of morphometry in the diagnosis of benign and malignant cutaneous lymphoid infiltrates; and to determine whether the sensitivity of detection of cutaneous T cell lymphoma (CTCL) could be improved by selectively measuring cells expressing proliferating cell nuclear antigen (PCNA). METHODS: 44 archival biopsy specimens were studied. These included cases of CTCL, non-specific chronic dermatitis, lichen planus and lupus erythematosus. PCNA was identified using a standard immunohistological technique. Reactive cells were identified using automatic colour discrimination, and the size and shape were determined interactively. Similar measurements were made on the total dermal lymphocyte population. RESULTS: There was no significant difference between the proportions of PCNA reactive cells in any of the diseases studied. The PCNA positive lymphocytes in CTCL were larger than those in lupus erythematosus and lichen planus and were more irregular in shape than those in chronic dermatitis. Differences were also seen in the total lymphocyte population. Plotting cell size and shape(fcircle) for PCNA cells together allowed CTCL to be differentiated from the inflammatory disorders with a sensitivity of 80% and a specificity of 93%. This was better than could be achieved using measurements made on the total cell population. CONCLUSIONS: This technique can be partly automated and could be useful in the differential diagnosis of cutaneous lymphoid infiltrates. The result are also of some interest in the further understanding of patterns of cell proliferation in skin associated lymphoid tissue.

Full text

PDF
129

Images in this article

131Image
on p.131

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amagai M., Hayakawa K., Amagai N., Kobayashi K., Onodera Y., Shimizu N., Nishikawa T. T cell receptor gene rearrangement analysis in mycosis fungoides and disseminated lymphocytoma cutis. Dermatologica. 1990;181(3):193–196. doi: 10.1159/000247922. [DOI] [PubMed] [Google Scholar]
  2. Bani D., Pimpinelli N., Moretti S., Giannotti B. Langerhans cells and mycosis fungoides--a critical overview of their pathogenic role in the disease. Clin Exp Dermatol. 1990 Jan;15(1):7–12. doi: 10.1111/j.1365-2230.1990.tb02009.x. [DOI] [PubMed] [Google Scholar]
  3. Cintorino M., del Vecchio M. T., de' Santi M. M., Lavarini E., Miracco C., Raffaelli M., Santopietro R., Leoncini L. Mycosis fungoides. Detection of OKT6+ cells by cytofluorographic analysis in one case. Am J Dermatopathol. 1987 Apr;9(2):114–119. [PubMed] [Google Scholar]
  4. Fine R. M. Clonal rearrangement of the T-cell receptor gene and the diagnosis of mycosis fungoides. Int J Dermatol. 1987 Apr;26(3):169–170. doi: 10.1111/j.1365-4362.1987.tb00884.x. [DOI] [PubMed] [Google Scholar]
  5. Fransway A. F., Winkelmann R. K. Chronic dermatitis evolving to mycosis fungoides: report of four cases and review of the literature. Cutis. 1988 May;41(5):330–335. [PubMed] [Google Scholar]
  6. Grogan T. M., Lippman S. M., Spier C. M., Slymen D. J., Rybski J. A., Rangel C. S., Richter L. C., Miller T. P. Independent prognostic significance of a nuclear proliferation antigen in diffuse large cell lymphomas as determined by the monoclonal antibody Ki-67. Blood. 1988 Apr;71(4):1157–1160. [PubMed] [Google Scholar]
  7. Hall P. A., Levison D. A., Woods A. L., Yu C. C., Kellock D. B., Watkins J. A., Barnes D. M., Gillett C. E., Camplejohn R., Dover R. Proliferating cell nuclear antigen (PCNA) immunolocalization in paraffin sections: an index of cell proliferation with evidence of deregulated expression in some neoplasms. J Pathol. 1990 Dec;162(4):285–294. doi: 10.1002/path.1711620403. [DOI] [PubMed] [Google Scholar]
  8. Hoppe R. T., Wood G. S., Abel E. A. Mycosis fungoides and the Sézary syndrome: pathology, staging, and treatment. Curr Probl Cancer. 1990 Nov-Dec;14(6):293–371. doi: 10.1016/0147-0272(90)90018-l. [DOI] [PubMed] [Google Scholar]
  9. Horiuchi Y., Tone T., Umezawa A., Takezaki S. Large cell mycosis fungoides at the tumor stage. Unusual T8, T4, T6 phenotypic expression. Am J Dermatopathol. 1988 Feb;10(1):54–58. doi: 10.1097/00000372-198802000-00007. [DOI] [PubMed] [Google Scholar]
  10. Jack A. S., Boylston A. W., Carrel S., Grigor I. Cutaneous T-cell lymphoma cells employ a restricted range of T-cell antigen receptor variable region genes. Am J Pathol. 1990 Jan;136(1):17–21. [PMC free article] [PubMed] [Google Scholar]
  11. Kartsonis J., Brettschneider F., Weissmann A., Rosen L. Mycosis fungoides bullosa. Am J Dermatopathol. 1990 Feb;12(1):76–80. doi: 10.1097/00000372-199002000-00011. [DOI] [PubMed] [Google Scholar]
  12. Lazar A. P., Caro W. A., Roenigk H. H., Jr, Pinski K. S. Parapsoriasis and mycosis fungoides: the Northwestern University experience, 1970 to 1985. J Am Acad Dermatol. 1989 Nov;21(5 Pt 1):919–923. doi: 10.1016/s0190-9622(89)70277-2. [DOI] [PubMed] [Google Scholar]
  13. LeBoit P. E., Zackheim H. S., White C. R., Jr Granulomatous variants of cutaneous T-cell lymphoma. The histopathology of granulomatous mycosis fungoides and granulomatous slack skin. Am J Surg Pathol. 1988 Feb;12(2):83–95. doi: 10.1097/00000478-198802000-00002. [DOI] [PubMed] [Google Scholar]
  14. Meissner K., Löning T., Rehpenning W. Mycosis fungoides und Sézary-Syndrom: diagnostische und prognostische Relevanz der Expression zellulärer Antigene. Hautarzt. 1991 Feb;42(2):84–91. [PubMed] [Google Scholar]
  15. Meissner K., Michaelis K., Rehpenning W., Löning T. Epidermal Langerhans' cell densities influence survival in mycosis fungoides and Sézary syndrome. Cancer. 1990 May 1;65(9):2069–2073. doi: 10.1002/1097-0142(19900501)65:9<2069::aid-cncr2820650930>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  16. Nickoloff B. J., Griffiths C. E. Intraepidermal but not dermal T lymphocytes are positive for a cell-cycle-associated antigen (Ki-67) in mycosis fungoides. Am J Pathol. 1990 Feb;136(2):261–266. [PMC free article] [PubMed] [Google Scholar]
  17. Nickoloff B. J. Light-microscopic assessment of 100 patients with patch/plaque-stage mycosis fungoides. Am J Dermatopathol. 1988 Dec;10(6):469–477. doi: 10.1097/00000372-198812000-00001. [DOI] [PubMed] [Google Scholar]
  18. Oliver G. F., Winkelmann R. K., Banks P. M. Unilesional mycosis fungoides: clinical, microscopic and immunophenotypic features. Australas J Dermatol. 1989;30(2):65–71. doi: 10.1111/j.1440-0960.1989.tb00419.x. [DOI] [PubMed] [Google Scholar]
  19. Payne C. M., Spier C. M., Grogan T. M., Richter L. C., Bjore C. G., Jr, Cromey D. W., Rangel C. S. Nuclear contour irregularity correlates with Leu-9-, Leu-8- cells in benign lymphoid infiltrates of skin. An ultrastructural morphometric and quantitative immunophenotypic analysis suggesting the normal T-cell counterpart to the malignant mycosis fungoides/Sézary cell. Am J Dermatopathol. 1988 Oct;10(5):377–389. [PubMed] [Google Scholar]
  20. Poppema S., Hepperle B. Restricted V gene usage in T-cell lymphomas as detected by anti-T-cell receptor variable region reagents. Am J Pathol. 1991 Jun;138(6):1479–1484. [PMC free article] [PubMed] [Google Scholar]
  21. Rieger E., Smolle J., Hoedl S., Juettner F. M., Kerl H. Morphometrical analysis of mycosis fungoides on paraffin-embedded sections. J Cutan Pathol. 1989 Feb;16(1):7–13. doi: 10.1111/j.1600-0560.1989.tb00002.x. [DOI] [PubMed] [Google Scholar]
  22. Schwartz B. R., Pinkus G., Bacus S., Toder M., Weinberg D. S. Cell proliferation in non-Hodgkin's lymphomas. Digital image analysis of Ki-67 antibody staining. Am J Pathol. 1989 Feb;134(2):327–336. [PMC free article] [PubMed] [Google Scholar]
  23. Simon G. T. The value of morphometry in the ultrastructural diagnosis of Mycosis fungoides. Ultrastruct Pathol. 1987;11(5-6):687–691. doi: 10.3109/01913128709048455. [DOI] [PubMed] [Google Scholar]
  24. Souchier C., Ffrench M., Berger F., Scoazec J. Y., Bryon P. A. Image analysis applied to proliferating cells in malignant lymphoma. Cytometry. 1988 May;9(3):201–205. doi: 10.1002/cyto.990090303. [DOI] [PubMed] [Google Scholar]
  25. Sperling M., Kaudewitz P., Braun-Falco O., Stein H. Reactivity of T cells in mycosis fungoides exhibiting marked epidermotropism with the monoclonal antibody HML-1 that defines a membrane molecule on human mucosal lymphocytes. Am J Pathol. 1989 May;134(5):955–960. [PMC free article] [PubMed] [Google Scholar]
  26. Streilein J. W. Skin-associated lymphoid tissue. Immunol Ser. 1989;46:73–96. [PubMed] [Google Scholar]
  27. Weinberg D. S. The role of cell cycle activity in the generation of morphologic heterogeneity in non-Hodgkin's lymphoma. Am J Pathol. 1989 Oct;135(4):759–770. [PMC free article] [PubMed] [Google Scholar]
  28. Whittaker S. J., Smith N. P., Jones R. R., Luzzatto L. Analysis of beta, gamma, and delta T-cell receptor genes in mycosis fungoides and Sezary syndrome. Cancer. 1991 Oct 1;68(7):1572–1582. doi: 10.1002/1097-0142(19911001)68:7<1572::aid-cncr2820680719>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  29. Yu C. C., Woods A. L., Levison D. A. The assessment of cellular proliferation by immunohistochemistry: a review of currently available methods and their applications. Histochem J. 1992 Mar;24(3):121–131. doi: 10.1007/BF01047461. [DOI] [PubMed] [Google Scholar]
  30. van der Putte S. C., Toonstra J., van Wichen D. F., van Unnik J. A., van Vloten W. A. Aberrant immunophenotypes in mycosis fungoides. Arch Dermatol. 1988 Mar;124(3):373–380. doi: 10.1001/archderm.124.3.373. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES