bromochloroacetic-acid and Sezary-Syndrome

In mycosis fungoides the malignant T cells express lymphocyte function-associated antigen-1, which allows them to bind to epidermal keratinocytes expressing the gamma interferon-inducible intercellular adhesion molecule-1. In this report, a patient with leukemic-stage mycosis fungoides (Sézary syndrome) had widespread erythematous dermal infiltrates containing malignant T cells, but without any epidermotropism. We discovered that the T cells expressed normal amounts of functional lymphocyte function-associated antigen-1, but the keratinocytes did not express significant levels of intercellular adhesion molecule-1, which was probably due to the inability of the malignant T cells to produce gamma interferon. These results support the concept that the inability of malignant T cells to enter the epidermis may contribute to emergence of more clinically aggressive T-cell clones that are no longer confined to the skin, but infiltrate the blood, lymph nodes, and viscera, as is seen in Sézary syndrome.

Topics: Aged; Antigens, Differentiation; Antigens, Surface; Cell Adhesion; Cell Adhesion Molecules; Cell Cycle; Epidermal Cells; Epidermis; HLA-DR Antigens; Humans; Immunoenzyme Techniques; Interferon-gamma; Keratins; Leukocytes, Mononuclear; Lymphocyte Function-Associated Antigen-1; Male; Receptors, Interleukin-2; Sezary Syndrome

Topics: Cell Line; Cell Movement; Chemotactic Factors; Epidermis; Humans; Keratins; Sezary Syndrome; T-Lymphocytes

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