THE IMMUNOLOGICAL AND CLINICOPATHOLOGIC HETEROGENEITY OF CUTANEOUS LYMPHOMAS OTHER THAN MYCOSIS-FUNGOIDES

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  • 1 January 1983
    • journal article
    • research article
    • Vol. 62  (2) , 464-472
Abstract
Patients (21) with non-Hodgkin''s lymphoma with cutaneous involvement, other than mycosis fungoides, were evaluated immunologically, histologically and clinically. Ten patients presented with skin disease alone, 7 with concurrent cutaneous and extracutaneous disease, and 4 with extracutaneous disease only. Of the 21 cases, 20 were nonepidermotropic tumors and were equally likely to express B or T phenotypes. None of the cases expressed a true histiocytic phenotype. Almost all cases expressed Ia and class I HLA determinants. Immunophenotypes were stable regardless of time interval, therapy or body site sampled in 7 of 8 patients studied serially. In contrast to mycosis fungoides, the T lymphomas exhibited noncerebriform cytology, tumor Ia expression, lack of mature helper T-cell phenotype, nonepidermotropic histology, a tendency for marrow involvement and presented as nodules rather than patches or plaques. Since each T lymphoma expressed an abnormal but uniform T-cell phenotype other than mature cytotoxic/suppressor or helper, the neoplastic population could be distinguished from reactive T cells. Reactive elements averaged 1/3 of the cellular infiltrates and were mainly T cells and macrophages. Langerhans cells were generally normal in number and distribution. Several histopathologic subtypes were identified with diffuse large cell lymphomas, including immunoblastic lymphomas, comprising 71% of cases (15/21). Prediction of the immunophenotype based on cytologic criteria was correct in 67% of cases (14/21). All errors occurred among the 13 high-grade lymphomas. Survival data were consistent with those of prior studies that have indicated that clinical course is dependent on stage and histologic subtype. Non-Hodgkin''s cutaneous lymphomas constitute an immunologically, histologically and clinically heterogeneous group of neoplasms.