Objectives: To study the role of immuno-histochemistry
and T-cell receptor (TCR) gamma gene rearrangement
analysis in the diagnosis of mycosis fungoides (MF).
Methods: The study design was retrospective, and 73
cases were selected from the archive of the Pathology
Department, School of Medicine, Cukurova University,
Adana, Turkey, between January 2004 and December 2009.
Thirty-nine MF cases with classical histomorphology,
16 cases with suspicious histomorphology for MF
as the inconclusive group, and 18 cases with benign
inflammatory dermatoses as the control group were
involved in the study. The slides were evaluated for the
presence or absence of the histopathological criteria for
MF. Immunohistochemically, CD3, CD4, and CD8
were performed in all cases, and their counts and CD4/
CD8 ratio were noted. Presence clonal TCR gamma
gene rearrangement was evaluated by polymerase chain
Results: The histopathological parameters suggestive
of MF were epidermotropism (p=0.000), presence
of Pautrier microabscess (p=0.004), and atypical
lymphocyte (p=0.000). Immunohistochemically, CD4
percentage (p=0.006) and CD4/CD8 ratio (p=0.010)
were statistically significant parameters with univariate
analysis. Clonality was present in 76.9% of MF cases
and 37.5% in the inconclusive group. Four of 6 clonality
positive cases in the inconclusive group were diagnosed
as MF in rebiopsies. The CD8 percentage was not
statistically different between the 3 groups.
Conclusion: In suspicious cases, CD4/CD8 ratio
and TCR gamma gene rearrangement can support
histopathology in early MF.