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Is immunohistochemical expression of GATA3 helpful in the differential diagnosis of transformed mycosis fungoides and primary cutaneous CD30-positive T cell lymphoproliferative disorders?

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Abstract

Mycosis fungoides with large cell transformation (MFLCT) can be difficult to distinguish from primary cutaneous CD30+ T cell lymphoproliferative disorders (PC CD30+ LPD), especially primary cutaneous anaplastic large cell lymphoma (PC-ALCL). This diagnostic distinction is critical for appropriate patient management. GATA3 has been proposed to be useful in the discrimination between these two entities. We identified 25 cases of MFLCT and 24 cases of PC CD30+ LPDs (including lymphomatoid papulosis (n=14), PC-ALCL (n=6), and CD30+ LPD, not otherwise specified (n=4)) diagnosed at our institution from 2002 to 2019. Sections from archived specimens were stained to evaluate for GATA3 expression by immunohistochemistry and compared among cutaneous CD30+ T cell LPDs. The majority of the MFLCT cohort had strong, diffuse expression of GATA3 ranging from 0 to 100% of dermal T cells (mean 53.20%) with 15/25 cases (60%) showing GATA3 expression greater than 50%, while the PC CD30+ LPD group showed variable, moderate GATA3 labeling ranging from 0 to 60% of dermal T cells (mean 23.26%), with 5/6 cases (83%) showing GATA3 expression less than 40% (p =0.003). The calculated sensitivity and specificity were 56% and 74%, while positive and negative predictive values were 70% and 61%, respectively. Based on the percent staining of positive cells, using 50% as a cutoff value for expression, GATA3 might be a useful immunohistochemical marker to discriminate MFLCT from PC CD30+ LPDs, including PC-ALCL.

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Acknowledgements

We thank Rachel Christiansen for her critical review of the manuscript. The skillful photographic assistance of Kim-Anh Vu is gratefully acknowledged.

Funding

Funding is provided by The N. Allen and Barbara B. Kannapell Fund for Melanoma Medical Oncology Research.

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Authors and Affiliations

  1. Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Katrina Collins, Phyu P. Aung, Priyadharsini Nagarajan, Jonathan L. Curry, Doina Ivan, Victor G. Prieto, Michael T. Tetzlaff & Carlos A. Torres-Cabala

  2. Department of Cytogenetics Technology Program, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jun Gu

  3. Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Auris Huen, Madeleine Duvic & Carlos A. Torres-Cabala

  4. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Roberto N. Miranda & Francisco Vega

Authors
  1. Katrina Collins
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  2. Jun Gu
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Contributions

All authors contributed to the study conception and design.

Conceptualization: Katrina Collins, Jun Gu, Phyu P Aung, Priyadharsini Nagarajan, Jonathan L Curry, Auris Huen, Doina Ivan, Victor G Prieto, Michael T Tetzlaff, Madeleine Duvic, Roberto N Miranda, Francisco Vega, Carlos A. Torres-Cabala. Methodology: Katrina Collins, Jun Gu, Phyu P Aung, Priyadharsini Nagarajan, Jonathan L Curry, Auris Huen, Doina Ivan, Victor G Prieto, Michael T Tetzlaff, Madeleine Duvic, Roberto N Miranda, Francisco Vega, Carlos A. Torres-Cabala. Formal analysis and investigation: Katrina Collins, Jun Gu, Phyu P Aung, Roberto N Miranda, Francisco Vega, Carlos A. Torres-Cabala. Writing—original draft preparation: Katrina Collins, Roberto N Miranda, Francisco Vega, Carlos A. Torres-Cabala. Writing—review and editing: Katrina Collins, Jun Gu, Phyu P Aung, Priyadharsini Nagarajan, Jonathan L Curry, Auris Huen, Doina Ivan, Victor G Prieto, Michael T Tetzlaff, Madeleine Duvic, Roberto N Miranda, Francisco Vega, Carlos A. Torres-Cabala. Funding acquisition: Francisco Vega, Carlos A. Torres-Cabala. Resources: Katrina Collins, Jun Gu, Francisco Vega, Carlos A. Torres-Cabala. Supervision: Jun Gu, Phyu P Aung, Roberto N Miranda, Francisco Vega, Carlos A. Torres-Cabala

Corresponding author

Correspondence to Carlos A. Torres-Cabala.

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The study has been conducted according to the guidelines of the local ethical committee.

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Collins, K., Gu, J., Aung, P.P. et al. Is immunohistochemical expression of GATA3 helpful in the differential diagnosis of transformed mycosis fungoides and primary cutaneous CD30-positive T cell lymphoproliferative disorders?. Virchows Arch 479, 377–383 (2021). https://doi.org/10.1007/s00428-021-03056-y

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  • DOI: https://doi.org/10.1007/s00428-021-03056-y

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