[485] CLA, TRAF1, BCL2, NFKB2, CD56, EMA and Fascin Expression in CD30+ Lymphoproliferative Disorders of the Skin
EM Sagatys, D Rezania, M Naghashpour, LF Glass, ME Kadin, HD Cualing. Moffitt Cancer Center, Tampa, FL; Genoptix Medical Laboratory, Carlsbad, CA; Roger Williams Hospital, Providence, RI
Background: Lymphomatoid papulosis (LyP), primary cutaneous (pcALCL) and systemic anaplastic large cell lymphoma (sALCL) are CD30+ lymphoproliferative disorders (LPD) with overlapping morphology, but widely different behavior. This study examines the role of BCL2, CD56, cutaneous lymphocyte antigen (CLA, skin homing ), EMA, Fascin, NFKB2, and tumor necrosis factor receptor (TNFR) associated factor 1 (TRAF1, intracellular trafficking) in differentiating CD30+ LPD in the skin.
Design: With IRB approval, formalin-fixed, paraffin-embedded biopsy specimens from 13 LyP, 9 pcALCL and 8 sALCL were selected from the MCC Archives from 2000-07. All cases were stained with the above antibodies using manufacturer's protocols. Manual morphometry and virtual flow cytometry were performed to quantitate antibody expression. Statistical analysis was performed using non-parametric analysis of variance (Kruskal-Wallis method).
Results:
| LyP | pcALCL | sALCL | |
| BCL2 | 37.0 14.8 | 18.712.7 | 69.521.1 |
| CLA | 52.425.1 | 28.612.7 | 6.57.6 |
| TRAF1 | 25.122.4 | 32.822.3 | 0.91.4 |
| NFKB2 | 100.00 | 98.93.3 | 76.832.5 |
| CD56 | 0.20.4 | 0.10.3 | 0 |
| EMA | 2.75.6 | 13.328.3 | 18.826.9 |
| Fascin | 16.412.7 | 47.631.7 | 43.144.7 |
There was no significant difference of TRAF1 between LyP and pcALCL (p>0.05), but significant differences between LyP and sALCL (p<0.01), and pcALCL and sALCL (p <0.001). CLA expression showed significant differences between LyP and pcALCL (p<0.05) and LyP and sALCL (p<0.001), with insignificant differences between pcALCL and sALCL (p>0.05). BCL2 showed significant differences between pcALCL and sALCL (p<0.001) but not between LyP and pcALCL (p>0.05) and LyP and sALCL (p>0.05). NFKB2 showed significant differences between LyP and sALCL (p<0.01) and pcALCL and sALCL (p<0.05). CD56 (p=0.5283), Fascin (p=0.2590), and EMA (p=0.1624) were not contributory.
Conclusions: There was significant differential expression of TRAF1 and CLA in LyP. TRAF1 was negative in sALCL. CLA differentiates LyP from pcALCL and sALCL. BCL2 may differentiate pcALCL from sALCL. NFKB2 may be useful in distinguishing pcALCL from sALCL. This study indicates potential utility of TRAF-1, CLA, BCL2 and possibly NFKB2 in separating systemic from primary cutaneous CD30+ LPD. CD56, Fascin and EMA were non-contributory.
Category: Dermatopathology
Monday, March 9, 2009 9:30 AM
Poster Session I Stowell-Orbison/Autopsy Award # 81, Monday Morning