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Mast Cell Tryptase and Microphthalmia Transcription Factor Effectively Discriminate Between Cutaneous Mast Cell Disorders and Leukemia Cutis: A Comparative Cytochemical and Immunohistochemical Study
Author(s) -
Sundram U.,
Natkunam Y.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320hb.x
Subject(s) - leukemia cutis , tryptase , pathology , cutis , mast cell , leukemia , medicine , microphthalmia associated transcription factor , myeloid leukemia , mastocytoma , cd117 , immunology , biology , cancer research , transcription factor , cd34 , biochemistry , gene , genetics , stem cell , tumor cells
Cutaneous mast cell disorders are uncommon but a subset of these disorders, especially mastocytoma, can histologically mimic leukemia cutis. Our objective was to employ a panel of cytochemical and immunohistolochemical markers to determine which markers would be most useful in distinguishing these entities. We studied 17 cases of cutaneous mast cell disorders (UP, TMEP, and mastocytoma) and 12 cases of leukemia cutis (myeloid, myelomonocytic and monocytic) with toluidine blue, Giemsa, pinacyanol erythrocyanate (PE), mast cell tryptase, microphthalmia transcription factor (MITF), CD117, myeloperoxidase, CD43 and CD68. We found that PE stained the majority of cases of mast cell disorders (11/15) but did not stain leukemia cutis. Tryptase and MITF stained all cases of mast cell disorders but not leukemia cutis. Although CD117 showed strong staining in all cases of mast cell disorders, it also stained up to 25% of cases of leukemia cutis (2/8). Staining for myeloperoxidase was specific to leukemia cutis but detected only leukemias with myeloid differentiation (6/12). Our results show that mast cell tryptase and microphthalmia transcription factor are equally effective in distinguishing mast cell disorders from leukemia cutis. Interestingly, pinacyanol erythrocyanate appears to be specific for mast cell disease, as no staining was seen in leukemia cutis.