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Highly Skewed Immunohistochemical αβ:γδ Ratios for T-Cell Receptors Can Be Detected in Reactive Duodenal Biopsies.

Archives of pathology & laboratory medicine 2026

de Castro GC, Bean GR, Wen KW

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[CONTEXT.—] T-cell receptors (TCRs) are classified as αβ- and γδ-chain groups.

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BibTeX ↓ RIS ↓
APA de Castro GC, Bean GR, Wen KW (2026). Highly Skewed Immunohistochemical αβ:γδ Ratios for T-Cell Receptors Can Be Detected in Reactive Duodenal Biopsies.. Archives of pathology & laboratory medicine. https://doi.org/10.5858/arpa.2025-0446-OA
MLA de Castro GC, et al.. "Highly Skewed Immunohistochemical αβ:γδ Ratios for T-Cell Receptors Can Be Detected in Reactive Duodenal Biopsies.." Archives of pathology & laboratory medicine, 2026.
PMID 41951224

Abstract

[CONTEXT.—] T-cell receptors (TCRs) are classified as αβ- and γδ-chain groups. T-cell lymphoma (TCL) has been shown to express either αβ or γδ TCRs. Immunohistochemical stains for TCR-BetaF1 (TCR-BF1) (αβ) and TCR-delta (γδ) have been used clinically for classifying and diagnosing TCL in various organs. Outside of celiac disease, T-cell expression and distribution of TCR-BF1 and TCR-delta in the duodenum are largely unknown.

[OBJECTIVE.—] To examine TCR-BF1 and TCR-delta expression in various duodenal pathologic processes.

[DESIGN.—] We collected 50 duodenal biopsy specimens with various inflammatory and infectious etiologies, such as celiac disease, inflammatory bowel disease, protein-losing enteropathy, chimeric antigen receptor T-cell (CAR-T)-related enteritis, and immune checkpoint inhibition. Five cases with no pathologic findings and 3 TCL cases were included for comparison. We performed immunohistochemistry for CD3, TCR-BF1, and TCR-delta on biopsy tissue. Low-power-field estimates and manual high-power-field counts were performed to assess TCR-BF1:TCR-delta ratios in T cells and the relative distribution of T cells in duodenal mucosa.

[RESULTS.—] In all non-TCL cases, TCR-BF1 T cells were more prevalent than TCR-delta T cells. Celiac disease showed less TCR-BF1:TCR-delta skewing than other conditions (mean, 1.97 versus 26.21-320).

[CONCLUSIONS.—] Expression of TCR-BF1 is more prevalent than TCR-delta in duodenal T cells in normal duodenum and across multiple nonneoplastic processes. Outside of celiac disease, the TCR-BF1:TCR-delta T-cell ratios can be highly skewed toward TCR-BF1 in such duodenal biopsy samples. As such, the assessment of TCR-BF1:TCR-delta T-cell ratios via immunohistochemistry can mistakenly infer T-cell monoclonality and thus should be interpreted with caution in the assessment of T-cell lymphoma.