bromochloroacetic-acid and Mycosis-Fungoides

Mycosis fungoides (MF) is a relatively rare cutaneous T-cell malignancy. Only two cases of MF with marked eosinophilia have been reported. In addition, MF with concomitant squamous cell carcinoma (SCC) occurring in the site of MF has not been reported. The author reports herein a very rare case of MF in the plaque stage showing pronounced eosinophilic infiltration, folliculotropic pattern, and in situ development of poorly differentiated squamous cell carcinoma (SCC). A 75-year-old man was found to show high prostate specific antigen (PSA, 13 hg/ml) and prostatic biopsy showed well differentiated prostatic adenocarcinoma of Gleason score 6. Imaging techniques showed no metastatic lesions. He was treated by estrogen therapy. At 80 years, he consulted our hospital because of erythematous patch in the trunk. Biopsy showed mild infiltrations of lymphocyte and eosinophils. The lesion disappeared spontaneously. At 82 years, he consulted our hospital of because of erythematous patch at the back, and biopsy showed mildly atypical lymphocytes positive for CD20 and CD45, but negative for CD30, CD45RO, S100 protein, and cytokeratin (CK). Lymphoma was suspected but not definite. The lesions spontaneously disappeared. At 86 ages, he also consulted our hospital because of plaques in the face. Biopsy showed proliferation of atypical lymphocytes, marked infiltration of mature eosinophils, marked infiltration of these cells in the fair follicles (folliculotropism), and poorly differentiated invasive SCC arising from follicular cells. An immunohistochemical analysis showed that the atypical lymphocytes are T-lymphoma cells with T-cell markers, cyclinD1, p53, and high Ki67 labeling (50%) but without B-cell markers, NK-cell markers and plasma cell markers. The eosinophils were mature, and lacked p53 and showed low Ki67 labeling (4%). The carcinoma was positive for CK, p53, cyclinD1, and high Ki67 labeling (35%). A diagnosis of MF in the plaque stage with marked non-neoplastic eosinophilic infiltration, marked folliculotropism, and coexistent poorly differentiated invasive SCC was made by the author. Post-biopsy imaging techniques showed no metastasis or lymphadenopathy in the body. The patient was now treated by chemotherapy.

Topics: Aged, 80 and over; Biomarkers, Tumor; Biopsy; Carcinoma, Squamous Cell; Cell Movement; Comorbidity; Cyclin D1; Drug Therapy; Eosinophils; Hair Follicle; Humans; Keratins; Male; Mycosis Fungoides; Neoplasms, Multiple Primary; Skin Neoplasms; Tumor Suppressor Protein p53

In all mammalian species so far examined, Langerhans cells or their precursors are the only epidermal cells expressing Ia antigens or their equivalents. In man, xeno-antisera raised in rabbits against purified B-lymphocyte cell membrane antigens were utilized to stain the Langerhans cells by either fluorescent or immunoferritin methods. As high proportion of the indeterminate cells in the epidermis also expressed HLA-DR antigens, and a relationship to Langerhans cells is suggested. Confirmation of these results was obtained in mouse. Alloantisera raised against I-A and I-EC subregion products again stained only Langerhans cells. Fluorescent, immunoperoxidase, and immunoferritin methods were used and confirmation of the specificity of the reaction was achieved at the electron microscope level. Langerhans cells were shown by ATPase staining to be absent from the epithelium of the central cornea, but present in the limbus. Population of the entire corneal epithelium surface was induced by application of irritants or contact sensitizing agents such as DNCB. Grafting of corneas either deficient or populated with Langerhans cells, to skin beds, may answer the question of the influence of such cells on allograft rejection.

Topics: Animals; Behcet Syndrome; Cattle; Cell Communication; Chickens; Chiroptera; Cricetinae; Dermatitis, Contact; Female; Guinea Pigs; Histiocytosis, Langerhans-Cell; Histocompatibility Antigens Class II; HLA Antigens; Humans; Keratins; Langerhans Cells; Lorisidae; Lymph Nodes; Lymphocytes; Mice; Mitosis; Mycosis Fungoides; Rabbits; Rats; Receptors, Immunologic; Sheep; Stomatitis, Aphthous; Swine; T-Lymphocytes; Thymus Gland

The immunocytochemical method with monoclonal antibodies to human and murine epidermis basal-cell antigen (BCAg) has been used in studies on the disorders in keratinocyte differentiation in epidermal tumors and mycosis fungoides. The fluorescence intensity augmented and BCAg distribution in the cytoplasm grew more diffuse as the degree of the tumor cell differentiation lowered. In mycosis fungoides the BCAg reaction has been positive first in the suprabasal layers; as the disease progressed, the fluorescence has involved the entire epidermis. The BCAg test is a sensitive tool for estimating the epidermal cell maturity in processes associated with impaired differentiation of keratinocytes.

Topics: Antibodies, Monoclonal; Antigens, Differentiation; Antigens, Neoplasm; Biopsy; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Epidermis; Humans; Immunohistochemistry; Keratins; Mycosis Fungoides; Skin Neoplasms

Five dark-skinned individuals presented with widespread well-demarcated hypopigmented lesions, biopsy of which revealed the histopathological features of mycosis fungoides. Ultrastructural studies showed focal invasion of the epidermis by mycosis cells with degenerative changes in adjacent melanocytes and keratinocytes. The majority of melanocytes exhibited swelling of cytoplasmic organelles and disordered melanogenesis with production of spherical incompletely melanized melanosomes. In addition disintegrating melanocytes were occasionally seen. Perifollicular repigmentation within hypopigmented areas occurred in two patients following clearing of the epidermal infiltrate with PUVA therapy. Mycosis fungoides may present with areas of cutaneous hypopigmentation.

Topics: Adolescent; Adult; Humans; Keratins; Male; Melanocytes; Microscopy, Electron; Middle Aged; Mycosis Fungoides; Pigmentation Disorders; Skin Neoplasms

The interactions between lymphocytes, Langerhals cells and keratinocytes, are described by electron microscopy in cutaneous lesions of malignant epidermotropic lymphomas (mycosis fungoides and Sézary's syndrome). Various contacts are observed between the different cells. During the degenerating process of keratinocytes, Langerhans cells disappear and histiocytic cells are bound to necrosing epidermal cells. The immunological process of Pautrier microabscess formation is discussed by comparison with ultrastructural aspects of cutaneous lecions of G.V.H. reaction in man.

Topics: Adult; Aged; Cell Nucleus; Epidermis; Female; Humans; Intercellular Junctions; Keratins; Langerhans Cells; Lymphocytes; Lymphoma; Male; Microscopy, Electron; Middle Aged; Mycosis Fungoides; Organoids; Sezary Syndrome; Skin Neoplasms