PMID- 21169992
OWN - NLM
STAT- MEDLINE
DCOM- 20110725
LR  - 20230210
IS  - 1530-0285 (Electronic)
IS  - 0893-3952 (Print)
IS  - 0893-3952 (Linking)
VI  - 24
IP  - 4
DP  - 2011 Apr
TI  - Specificity of IRF4 translocations for primary cutaneous anaplastic large cell 
      lymphoma: a multicenter study of 204 skin biopsies.
PG  - 596-605
LID - 10.1038/modpathol.2010.225 [doi]
AB  - Current pathologic criteria cannot reliably distinguish cutaneous anaplastic 
      large cell lymphoma from other CD30-positive T-cell lymphoproliferative disorders 
      (lymphomatoid papulosis, systemic anaplastic large cell lymphoma with skin 
      involvement, and transformed mycosis fungoides). We previously reported IRF4 
      (interferon regulatory factor-4) translocations in cutaneous anaplastic large 
      cell lymphomas. Here, we investigated the clinical utility of detecting IRF4 
      translocations in skin biopsies. We performed fluorescence in situ hybridization 
      (FISH) for IRF4 in 204 biopsies involved by T-cell lymphoproliferative disorders 
      from 182 patients at three institutions. In all, 9 of 45 (20%) cutaneous 
      anaplastic large cell lymphomas and 1 of 32 (3%) cases of lymphomatoid papulosis 
      with informative results demonstrated an IRF4 translocation. Remaining 
      informative cases were negative for a translocation (7 systemic anaplastic large 
      cell lymphomas; 44 cases of mycosis fungoides/Sezary syndrome (13 transformed); 
      24 peripheral T-cell lymphomas, not otherwise specified; 12 CD4-positive 
      small/medium-sized pleomorphic T-cell lymphomas; 5 extranodal NK/T-cell 
      lymphomas, nasal type; 4 gamma-delta T-cell lymphomas; and 5 other uncommon 
      T-cell lymphoproliferative disorders). Among all cutaneous T-cell 
      lymphoproliferative disorders, FISH for IRF4 had a specificity and positive 
      predictive value for cutaneous anaplastic large cell lymphoma of 99 and 90%, 
      respectively (P=0.00002, Fisher's exact test). Among anaplastic large cell 
      lymphomas, lymphomatoid papulosis, and transformed mycosis fungoides, specificity 
      and positive predictive value were 98 and 90%, respectively (P=0.005). FISH 
      abnormalities other than translocations and IRF4 protein expression were seen in 
      13 and 65% of cases, respectively, but were nonspecific with regard to T-cell 
      lymphoproliferative disorder subtype. Our findings support the clinical utility 
      of FISH for IRF4 in the differential diagnosis of T-cell lymphoproliferative 
      disorders in skin biopsies, with detection of a translocation favoring cutaneous 
      anaplastic large cell lymphoma. Like all FISH studies, IRF4 testing must be 
      interpreted in the context of morphology, phenotype, and clinical features.
FAU - Wada, David A
AU  - Wada DA
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 
      55905, USA.
FAU - Law, Mark E
AU  - Law ME
FAU - Hsi, Eric D
AU  - Hsi ED
FAU - Dicaudo, David J
AU  - Dicaudo DJ
FAU - Ma, Linglei
AU  - Ma L
FAU - Lim, Megan S
AU  - Lim MS
FAU - Souza, Aieska de
AU  - Souza Ad
FAU - Comfere, Nneka I
AU  - Comfere NI
FAU - Weenig, Roger H
AU  - Weenig RH
FAU - Macon, William R
AU  - Macon WR
FAU - Erickson, Lori A
AU  - Erickson LA
FAU - Ozsan, Nazan
AU  - Ozsan N
FAU - Ansell, Stephen M
AU  - Ansell SM
FAU - Dogan, Ahmet
AU  - Dogan A
FAU - Feldman, Andrew L
AU  - Feldman AL
LA  - eng
GR  - P50 CA097274/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20101217
PL  - United States
TA  - Mod Pathol
JT  - Modern pathology : an official journal of the United States and Canadian Academy 
      of Pathology, Inc
JID - 8806605
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Interferon Regulatory Factors)
RN  - 0 (interferon regulatory factor-4)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers, Tumor/analysis/*genetics
MH  - Biopsy
MH  - Child
MH  - Child, Preschool
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Interferon Regulatory Factors/*genetics
MH  - Lymphoma, Large-Cell, Anaplastic/genetics
MH  - Lymphoma, Primary Cutaneous Anaplastic Large Cell/chemistry/*genetics/pathology
MH  - Lymphomatoid Papulosis/genetics
MH  - Lymphoproliferative Disorders/*genetics/metabolism/pathology
MH  - Male
MH  - Middle Aged
MH  - Mycosis Fungoides/genetics
MH  - Predictive Value of Tests
MH  - Sensitivity and Specificity
MH  - Skin Neoplasms/chemistry/*genetics/pathology
MH  - *Translocation, Genetic
MH  - United States
MH  - Young Adult
PMC - PMC3122134
MID - NIHMS297863
COIS- Disclosure/Conflict of Interest Mayo Clinic and authors MEL, AD, and ALF have a 
      potential financial interest in technology associated with this research. Mayo 
      Clinic has filed a non-provisional patent application for that technology.
EDAT- 2010/12/21 06:00
MHDA- 2011/07/26 06:00
PMCR- 2011/10/01
CRDT- 2010/12/21 06:00
PHST- 2010/12/21 06:00 [entrez]
PHST- 2010/12/21 06:00 [pubmed]
PHST- 2011/07/26 06:00 [medline]
PHST- 2011/10/01 00:00 [pmc-release]
AID - S0893-3952(22)02894-0 [pii]
AID - 10.1038/modpathol.2010.225 [doi]
PST - ppublish
SO  - Mod Pathol. 2011 Apr;24(4):596-605. doi: 10.1038/modpathol.2010.225. Epub 2010 
      Dec 17.