A case of lymphomatoid granulomatosis (LYG) involving the lungs, skin, stomach, and possibly the left kidney in a 60‐year‐old man is presented. The infiltrates in the lungs, stomach, and skin showed a polymorphic appearance, and consisted predominantly of lymphocytes of mature and blastic form and of a few neutrophils, plasma cells, and histiocytes. Most lymphoid cells showed irregularly shaped nuclei and clustered dense bodies, characteristics indicative of T lymphocytes. An immunohistochemical study confirmed the T cell origin of the lymphocytes; i.e. they were positive for Leu‐1, Leu‐3a and la‐like antigens but negative for Leu‐2a antigen and the antibodies against light chains. The homogeniety of the major population of infiltrates in LYG indicates that at least some forms of LYG may be neoplastic or pre‐neoplastic lymphocytic disorders which may ultimately progress to malignant lymphoma. ACTA PATHOL. JPN. 35 : 711–721, 1985.

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In order to characterize the benign and malignant proliferation of lymphoid cells in skin, we compared surface markers and cytoplasmic organelles of cells in cutaneous lymphoid hyperplasia (CLH), lymphomatoid papulosis (LP), mycosis fungoides (MF), Sézary's syndrome (SS) and primary cutaneous malignant lymphoma (ML). The immunohistochemical study showed cells with both T - and B-cell markers in CLH,LP and early MF, whereas cells with only the T-cell marker were seen in late MF, SS and ML. T-cells in all cutaneous lesions possessed the surface marker common to T-cells of peripheral lymph nodes, and not that of central thymus cells. Cutaneous T-cells contained clustered or scattered dense core granules. Although no specific organelles indicative of benign or malignant lymphoid proliferation were found, there were several ultrastructural features that could help identifying each form of cutaneous lymphoid lesions. These included clustered or scattered dense-core granules, the variable degree of nuclear convolutions as well as dendritic arborization, and the presence or absence of 10 nm filaments.

Combination chemotherapy (DTIC and VCR plus a new derivative of nitrosourea, ACNU) with a new immunoadjuvant of OK432 were evaluated as treatment for disseminated malignant melanoma. Eight subjects with this chemoimmunotherapy showed a significant increase in survival rate (p=0.037 at 8 months), when compared with 11 subjects on other therapy. The regimens were minimally myelo‐suppressive and toxic to liver functions. Cellular immunity with specific mitogens of autologous and allogeneic melanoma cells (MLTC) and non‐specific mitogens of PHA, Con A and PWM was well preserved. Cell‐mediated cytotoxicity against autologous melanoma cells appeared to be stimulated in a way similar to that which occurs with BCG immunoadjuvant therapy.