Cardiac involvement and molecular staging in a fatal case of mycosis fungoides

Polymerase chain reaction (PCR) amplification of T-cell receptor-gamma gene rearrangement was used for molecular staging in a case of primary cutaneou s T-cell lymphoma (CTCL) with fatal evolution, Although initial evaluation was negative for systemic involvement, the patient died due to heart failur e, Autopsy findings revealed lymphomatous myocardial infiltration, but othe r tissues and organs examined, including lymph nodes, liver, spleen, lung a nd bone marrow, appeared to be free of disease, Molecular analysis from fro zen samples obtained during the initial evaluation, as well as paraffin-emb edded material obtained during autopsy, revealed the presence of clonal rea rranged bands in all tissues examined except the bone marrow. Subsequent hy bridization of PCR products with a tumour-specific oligoprobe confirmed the PCR results, suggesting widespread dissemination of the lymphomatous proce ss. The use of molecular analysis can add significant information about the extent of disease in patients with CTCL and may be helpful in the establis hment of therapeutic options.