Multispectral Imaging Approach to the Diagnosis of a CD20: A Case Report+: A Case Report Cutaneous T-cell Lymphoproliferative Disorder: A Case Report

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Expression of the pan B-cell marker CD20 by T-cell lymphoproliferative disorders is exceedingly rare. We present a 52-year-old man with a unilesional cutaneous CD20+ T-cell lymphoproliferative disorder. Multispectral imaging analysis of CD3–CD20 double-stained lesional tissue sections allowed (1) the visualization of double-positive T lymphocytes in situ with sensitivity superior to that of conventional immunohistochemistry and (2) the quantitative assessment of marker coexpression. Here, 23% of CD3+ signals in the patient's lesion were also CD20+, whereas 38% of CD20 + signals were also CD3+. In contrast, both parameters were below 1% in the tonsil control. Overall, the percentage of double-positive cells in lesional skin was 35%, although only 0.4% of such cells were detected in the tonsil. This is the first demonstration of aberrant CD20 expression by skin-infiltrating T cells using multispectral imaging.

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