{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:42:16Z","timestamp":1790862136866,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2018,3,17]]},"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Substantial clinicopathological overlap exists between cutaneous T-cell lymphoma (CTCL) and benign conditions, leading to diagnostic difficulties. We sought to delineate the utility of high-throughput sequencing (HTS) across a spectrum of histological findings in CTCL and reactive mimics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred skin biopsies obtained for clinical concern for CTCL were identified, comprising 25 cases each from four histological categories: \u2018definitive CTCL\u2019, \u2018atypical lymphoid infiltrate, concerning for CTCL\u2019, \u2018atypical lymphoid infiltrate, favour reactive\u2019 or \u2018reactive lymphoid infiltrate\u2019. T-cell receptor gamma chain gene (TRG) PCR and T-cell receptor beta chain gene HTS were performed on both skin biopsy and concurrently collected peripheral blood; most peripheral blood samples were also analysed by flow cytometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Histologically defined CTCL specimens had significantly higher clonality scores and T-cell fractions via HTS than all other groups (all p&lt;0.002\u2009and p&lt;0.03, respectively). HTS was more diagnostically specific than TRG PCR in skin (100% vs 88%), while diagnostic sensitivity (68% vs 72%) and accuracy (84% vs 80%) were similar. TRG PCR and flow cytometry performed on blood were the least diagnostically useful assays. Some identically sized peaks detected by TRG PCR in concurrent skin and peripheral blood specimens were non-identical by HTS analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HTS, by assessing both clonality and T-cell fractions in skin biopsies, is a powerful tool to aid in the diagnosis of CTCL. It is more specific than TRG PCR in distinguishing definitive CTCL from reactive and indeterminate histology. Identically sized peaks by TRG PCR, typically interpreted to be clonally related, are not always clonally identical by sequencing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jclinpath-2018-205004","type":"journal-article","created":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T12:22:32Z","timestamp":1523362952000},"page":"814-820","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Role of high-throughput sequencing in the diagnosis of cutaneous T-cell lymphoma"],"prefix":"10.1136","volume":"71","author":[{"given":"Bryan","family":"Rea","sequence":"first","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Haun","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Emerson","sequence":"additional","affiliation":[{"name":"Adaptive Biotechnologies, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Vignali","sequence":"additional","affiliation":[{"name":"Adaptive Biotechnologies, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midhat","family":"Farooqi","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Samimi","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalie","family":"Elenitsas","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Kirsch","sequence":"additional","affiliation":[{"name":"Adaptive Biotechnologies, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bagg","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,4,10]]},"reference":[{"key":"2025092505382458000_71.9.814.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-09-3502"},{"key":"2025092505382458000_71.9.814.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.07.049"},{"key":"2025092505382458000_71.9.814.3","doi-asserted-by":"crossref","first-page":"472","DOI":"10.2340\/00015555-1971","article-title":"Delay in the histopathologic diagnosis of mycosis fungoides","volume":"95","author":"Skov","year":"2015","journal-title":"Acta Derm Venereol"},{"key":"2025092505382458000_71.9.814.4","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23756"},{"key":"2025092505382458000_71.9.814.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/913523","article-title":"The role of molecular pathology in the diagnosis of cutaneous lymphomas","volume":"2012","author":"Raess","year":"2012","journal-title":"Patholog Res Int"},{"key":"2025092505382458000_71.9.814.6","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3007420"},{"key":"2025092505382458000_71.9.814.7","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaa9122"},{"key":"2025092505382458000_71.9.814.8","doi-asserted-by":"publisher","DOI":"10.1054\/modi.2001.27056"},{"key":"2025092505382458000_71.9.814.9","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-04-217604"},{"key":"2025092505382458000_71.9.814.10","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms3680"},{"key":"2025092505382458000_71.9.814.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2011.09.001"},{"key":"2025092505382458000_71.9.814.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.molonc.2015.09.003"},{"key":"2025092505382458000_71.9.814.13","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1611421113"},{"key":"2025092505382458000_71.9.814.14","doi-asserted-by":"publisher","DOI":"10.1158\/2326-6066.CIR-15-0240"},{"key":"2025092505382458000_71.9.814.15","doi-asserted-by":"publisher","DOI":"10.1158\/2326-6066.CIR-16-0013"},{"key":"2025092505382458000_71.9.814.16","doi-asserted-by":"publisher","DOI":"10.1038\/nature13954"},{"key":"2025092505382458000_71.9.814.17","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-013-1446-2"},{"key":"2025092505382458000_71.9.814.18","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-13-3231"},{"key":"2025092505382458000_71.9.814.19","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.det.2015.05.002","article-title":"Pathologic diagnosis of cutaneous lymphomas","volume":"33","author":"Kempf","year":"2015","journal-title":"Dermatol Clin"},{"key":"2025092505382458000_71.9.814.20","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000153121.57515.c6"},{"key":"2025092505382458000_71.9.814.21","doi-asserted-by":"publisher","DOI":"10.2353\/jmoldx.2010.090123"},{"key":"2025092505382458000_71.9.814.22","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5701109"},{"key":"2025092505382458000_71.9.814.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06649.x"},{"key":"2025092505382458000_71.9.814.24","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.det.2015.06.001","article-title":"Evaluation, diagnosis, and staging of cutaneous lymphoma","volume":"33","author":"Olsen","year":"2015","journal-title":"Dermatol Clin"},{"key":"2025092505382458000_71.9.814.25","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2001.04014.x"},{"key":"2025092505382458000_71.9.814.26","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-03-055749"},{"key":"2025092505382458000_71.9.814.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.04.030"},{"key":"2025092505382458000_71.9.814.28","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP5TYGBVW4ZITR"},{"key":"2025092505382458000_71.9.814.29","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-06-2220"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2018-205004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:38:33Z","timestamp":1758803913000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2018-205004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,10]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2018,8,15]]},"published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1136\/jclinpath-2018-205004"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2018-205004","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.733876169.793573962","asserted-by":"object"}]},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,10]]}}}