Phenotypic Characterization of Lymphocyte Subsets in Mycosis Fungoides: Comparison with Large Plaque Parapsoriasis and Benign Chronic Dermatoses

Abstract

Altogether, 209 skin biopsies from 103 patients with mycosis fungoides (MF), large plaque parapsoriasis (LPP), and benign chronic dermatoses (BCD) have been examined immunohistologically with the use of a panel of 21 monoclonal antibodies against lymphoid cells and their subsets. All the infiltrates contained a mixture of T-lymphocytes, Langerhans cells, and other types of HLA-DR-positive dermal macrophages. The neoplastic T-cells in MF lesions expressed proliferation-(transferrin receptor) and activation-(the OKT10 antigen) associated markers more frequently than the T-cells in LPP and BCD. In other respects, the neoplastic T-cells in plaque lesions of MF resembled those seen in LPP and BCD; and most of these cases demonstrated a clear predominance of T-cells of helper/inducer type. The neoplastic T-cells in tumor lesions of MF were much more heterogeneous in phenotype. Only eight of these cases could be classified as T-helper neoplasms. In the remaining ten tumor cases, the neoplastic cells expressed either suppressor/cytotoxic or aberrant T-cell phenotypes. There were no phenotypic differences between the "classical" tumor stages and MF d'emblee cases. The data indicate that the early lesions of MF show an immunohistologic reaction pattern common to many immune responses of the skin and that the neoplastic cells in the advanced stages are more heterogeneous in phenotype than previously recognized.

Clinical features associated with transformation of cerebriform T‐cell lymphoma to a large cell process

“…CTCL is generally considered a neoplasm of mature T-helper cells (Broder et al, 1976;Kung et al, 1981;Haynes et al, 1982;Wood et al, 1982;Chu et al, 1984;Nasu et al, 1985;Ralflciaer et al, 1985) but a small number of T-suppressor cases have been reported (Bennett et al, 1984;Ralfkiaer et al, 1985;Bennett et al, 1984;Picker et al, 1987). Only a few cases of transformed CTCL have been studied, and fewer still reported with phenotypic analysis of pre-or posttransformation (Dmitrovsky et al, 1987;Salhany et al, 1988).…”

Density of neoplastic lymphoid infiltrate, CD8+ T cells, and CD1a+ dendritic cells in mycosis fungoides

“…Neoplastic cells typically express the CD3+/CD4+ T helper phenotype; other T cell antigens, such as CD2, CD5, and CD7, can be hypoexpressed or lost in the advanced stages of the disease. [3][4][5][6] Early MF, showing a mild T cell lymphoid infiltrate, is hard to differentiate histologically from superficial dermatosis; diagnosis can be supported by the demonstration of monoclonal rearrangement of T cell receptor (TCR) genes and/or T cell antigen loss. 7 8 There is an ongoing debate on whether these difficult cases should be considered as early lymphoma capa-ble of progression, frustre lymphoma with no risk of evolution, or an altogether different entity unrelated to MF.…”

Proliferative Activity of Epidermal and Dermal T Lymphocytes in Mycosis fungoides

“…These results indicated a pos sibility that the epidemial T cell population was maintained not only by the migration of the dermal T cells but also by the in situ proliferation within the epidermis. In MF, Langerhans cell/T cell interactions have been suggested for the formation of Pautrier's microabscess, where Langerhans cells were found to cluster close to the infiltrated T cells [22], In addition to the T cell migration from the dermis, in situ proliferation might also contribute to the continuous recruitment of the epidermal T cells resulting in the forma tion of Pautrier's microabscesses.…”