![]() ThereĪre 4 distinct clinical (T) stages of mycosis fungoides in the Nearly 50% of all primary cutaneous lymphomas ( 2, 3, 6). Mycosis fungoides is the most common subtype of CTCL, comprising Indolent clinical behavior and aggressive behavior, such as thatĮxpressed by Sèzary syndrome lymphomas/leukemias ( 1, 3– 5). Organization's classical categorization of CTCL is divided into ThereĪre multiple variants of CTCL, which are classified on the basis of Individuals in the US newly diagnosed annually ( 1, 2). It accounts for 80 to 85% ofĪll primary cutaneous lymphomas, with approximately 1,000 HTS is a highly specific molecular test for identifying CTCL in peripheral blood and skin biopsy specimens however, our findings suggest a need for a continued search for more sensitive tests for early‑stage CTCL.Ĭutaneous T-cell lymphoma (CTCL) is the most common Peripheral blood testing was less sensitive than tissue testing (flow cytometry 14%, PCR 41%, HTS 33%) in peripheral blood, HTS was the most specific test (flow cytometry, 70% PCR, 62.5% and HTS, 100%). However, flow cytometry and PCR had insufficient DNA quantities in 29 and 15% of the specimens, respectively. In tissue biopsies, flow cytometry (64%), PCR (71%) and HTS (69%) shared similar sensitivities flow cytometry had the highest specificity (93%), followed by HTS (86%) and PCR (76.9%). Fifty‑five patients, with a total of 68 skin biopsies and peripheral blood draws, were evaluated using flow cytometry, PCR‑TCRGR, and HTS‑TCRGR to determine the sensitivity and specificity of each ancillary test. In a subset of patients the performance of HTS was compared to flow cytometry and conventional TCRGR analysis via polymerase chain reaction (PCR). This study aimed to evaluate the performance of the various ancillary testing modalities used to diagnose early‑stage CTCL. Even with all of these tools, CTCL can take as long as a decade to definitively diagnose, potentially delaying treatment options and causing patient anxiety. Advances in genomic sequencing, including high‑throughput sequencing (HTS), can be used to identify specific clones of rearranged TCR genes. Current diagnostic tools include clinical examination, histomorphologic analysis, immunohistochemistry, flow cytometry of peripheral blood and/or lesional tissue, and evaluation of T‑cell receptor (TCR) clonality by gene rearrangement analysis (TCRGR). Cutaneous T‑cell lymphoma (CTCL) is difficult to diagnose at an early stage.
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