| Objective:Cutaneous pseudolymphomas (CPL) is similar to cutaneous malignant lymphoma in histology. But its clinical features have the benign biological behavior and do not match entirely the diagnostic standard of cutaneous malignant lymphoma. Although the immunohistochemistry method can detect its type, it can not discriminate benign and malignance and just be used as a complementary treatment means. In this experiment, the expression of CD3, CD20 and CD45RO in 28 cases of CPL pathological tissues is detected by two-step immunohistochemistric method to typing these CPL cases. The gene rearrangement of TCR-y and IgH are also tested by Polymerase Chain Reaction (PCR). Both of them is aimed to make a reference to the clinical diagnosis of CPL.Methods:Choose 28 cases of well-preserved paraffin embedding tissues of CPL in Tianjin Changzheng Hospital, which have been diagnosed in clinic and pathology from March 2002 to July 2008. Both sexes were about equally represented. An age range from 21 to 80 is covered and the average age is (46.60±18.72).10 cases of lichen planus paraffin embedding tissues is chosen as the control group. There are 7 cases of male and 3 cases of female, which cover the age range of 17 to 66 and have a average age of (43.52±12.75). In brief, the sex structure and age differences have no statistical difference, which proved comparability. Applying immunocytochemistry stain method to the 28 cases of paraffin embedding tissues of CPL and use two-step immunohistochemistric method to detect the expression of CD3, CD20 and CD45R0 in these skin lesions. The DNA extracted from skin biopsy paraffin embedding tissues is also used as a template to detect the TCR-γand IgH gene rearrangement in PCR method.10 cases of lichen planus are chosen as control group and T-cell and B-cell lymphoma are assigned to positive control. The results of experiment are statistically analyzed computed by the software SPSS13.0. The immunohistochemistric data is processed by using variance analysis method. The tournament-method comparisons are detected by dunnett-t. Gene rearrangement result is also detected by Fisher's exact propability method. The condition of P<0.05 is considered to have statistical significance.Results:In the aspect of histopathology, the tissues of 28 CPL skin lesion in patient group revealed plenty of lymphocytic infiltration in the shallow lay of dermis. The result of immunohistochemistry indicate that among 28 cases in patient group, there were 13 cases with mainly positive expression of CD3 and CD45RO, which can be recognized as TCPL. Other 15 cases have the mainly positive expression of CD20 and can be recognize as BCPL. In the result of TCR-y,8 cases in case group appear smear band, which other 20 cases express negative and no one express positive. After Fisher exact probability test, the difference of TCR-y rearrangement ratio between CPL group and LP is not statistically significant (P=0.615). In the result of IgH,1 cases in case group appear smear band, which other 9 cases express negative and no one express positive. The others in the two group express negative. The difference of two group has no statistical significance. After the same test, the difference of IgH rearrangement ratio between CPL group and LP is not statistically significant (P=0.462).Conclusion:The partial pathological lymphoid infiltration in the CPL skin lesion are T cells with the expression of CD3 and CD45RO, while others lymphoid infiltration are B cell with the expression CD20. There are no obvious TCR-y and IgH gene rearrangement existing in lymphocyte of CPL tissue. Compared with the situation of the LP skin lesions with biological benign, it is no evident difference. The detection of TCR-y and IgH gene rearrangement might have a important reference value for the diagnosis of malignancy status of CPL.
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