Premium
Detailed analysis of the T‐cell lymphocytic infiltrate in penile lichen sclerosus: an immunohistochemical and molecular investigation
Author(s) -
Regauer S,
BehamSchmid C
Publication year - 2006
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2006.02406.x
Subject(s) - t cell receptor , foreskin , biology , antigen , lichen sclerosus , polymerase chain reaction , cytotoxic t cell , microbiology and biotechnology , pathology , immunology , t cell , immune system , medicine , gene , cell culture , genetics , in vitro
Aim : To determine the extent of clonal outgrowth in the lymphocytic tissue infiltrate of lichen sclerosus (LS). The presence of T cells with a monoclonally rearranged T‐cell receptor γ‐gene (TCRγ) has been described in up to 50% of biopsies of vulvar and penile LS. Material and results : We analysed 33 foreskin specimens with LS for the presence of clonal T cells by conventional polymerase chain reaction (PCR) analysis and with TCRγ‐PCR‐based fluorescent fragment analysis. Eighteen of 33 patients revealed a band indicating a monoclonally rearranged TCRγ on conventional PCR analysis. Subsequent TCRγ‐PCR‐based fluorescent fragment analysis identified 8/18 patients with monoclonal T‐cell DNA ranging from 1.4% to 23.1% of total T‐cell DNA analysed and a size range from 56 to 72 base pairs. Four of 18 patients had an oligoclonal and 6/18 patients revealed a polyclonal banding pattern. The lymphocytic infiltrate contained low numbers of γδ T cells and cytotoxic T cells in comparable numbers to the low percentage of clonal TCRγ DNA. Conclusions : The low percentage of clonal TCRγ DNA argues against a systemic neoplastic disease, but rather for a local immune disorder. The target antigen of the clonal outgrowth is unknown, but an exaggerated antigen‐dependent proliferation of T cells due to chronic local antigen exposure, probably an infectious antigen, is the most likely explanation.