Real-World Experience With TRBC1 Immunohistochemistry Across Cutaneous T-Cell Lymphoma Subtypes:A Large…

Cohort studyModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc· Aug 2026

Real-World Experience With TRBC1 Immunohistochemistry Across Cutaneous T-Cell Lymphoma Subtypes:A Large Cohort Study.

Anna Sarah Erem, Nicollette Pepin, Yoni Sacknovitz … Alejandro A Gru

Read paper

HematopathologyCohort studyDiagnosisQ1IF 6.6

TRBC1 immunohistochemistry showed 85.8% sensitivity, 79.8% specificity for T-cell clonality in cutaneous lymphomas

Real-World Experience With TRBC1 Immunohistochemistry Across Cutaneous T-Cell Lymphoma Subtypes:A Large Cohort Study.

Anna Sarah Erem … Alejandro A Gru

Modern pathology · Aug 2026 · Q1 in Pathology

Methods

The analytic cohort comprised 665 biopsies (566 patients) with paired T-cell receptor (t-cell receptor) clonality testing, classified clinicopathologically as mycosis fungoides (MF-Patch, MF-Plaque, MF-Tumor, MF-Folliculotropic), MF/Sézary syndrome, primary cutaneous small/medium T-cell lymphoproliferative disorder, other cutaneous T-cell lymphoma-cutaneous lymphoproliferative disorder, or reactive.

n = 566 patients

Results

TRBC1 correctly flagged most true T-cell clones, missing few

Sensitivity

85.8%

Specificity

79.8%

More results

Monotypic TRBC1 predicted neoplasia, with odds rising with infiltrate density: MF-Patch (odds ratio 5.41), MF-Plaque (10.40), MF/Sézary syndrome with MF-Tumor (15.19), and cutaneous T-cell lymphoma-cutaneous lymphoproliferative disorder (18.16).

More results

Polytypic TRBC1 was associated with reactive disease (odds ratio 53.65), effectively excluded clonality (negative likelihood ratio 0.18); and was uniformly observed in an independent 270-biopsy reactive cohort.

“

Conclusion

These findings support a TRBC1-first approach, reserving reflex t-cell receptor testing for borderline expression or clinicopathologic discordance, preserving diagnostic accuracy while reducing molecular testing and reimbursement-based costs.

Real-World Experience With TRBC1 Immunohistochemistry Across Cutaneous T-Cell Lymphoma Subtypes:A Large Cohort Study.

Real-World Experience With TRBC1 Immunohistochemistry Across Cutaneous T-Cell Lymphoma Subtypes:A Large Cohort Study.

Related papers