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At least 793 records · Page 44Linked to original sources
PubMed1999

Expression of cytotoxic proteins by neoplastic T cells in mycosis fungoides increases with progression from plaque stage to tumor stage disease.

Granzyme B (GrB) and T-cell-restricted intracellular antigen (TIA-1) are cytotoxic proteins that are specifically expressed by cytotoxic CD4 or CD8 positive T cells and natural killer cells. Recent studies demonstrated frequent expression of GrB and TIA-1 by neoplastic cells in primary cutaneous CD30(+) large T-cell lymphomas and lymphomatoid papulosis but not in CD30(-) large T-cell lymphomas. In the present study, 74 biopsies from 54 patients with mycosis fungoides (MF) were investigated for the expression of GrB and TIA-1 using immunohistochemistry on paraffin sections. Staining of more than 10% of the neoplastic T cells for GrB or TIA-1 was considered positive. All but two follow-up biopsies had been obtained from patients without extracutaneous disease at the time of biopsy. Expression of TIA-1 and GrB was found in 33 (45%) and 14 (19%) of 74 MF biopsies, respectively. Comparison of biopsies from T3NoMo-stage MF (n = 27) and T2NoMo-stage MF (n = 45) showed increased expression of TIA-1 (55 versus 37%) and GrB (33 versus 9%) in T3NoMo-stage MF. Evaluation of multiple sequential biopsies from successive stages of MF also revealed an increase in the GrB/TIA-1 expression with tumor progression in five of eight cases. A clearcut relation between the expression of TIA-1 and/or GrB and the type of skin lesion biopsied was found. Considering all 74 biopsies, expression of TIA-1 and GrB was found in 18 of 50 (35%) and 5 of 50 (10%) patches or plaques, 9 of 16 (55%) and 3 of 16 (20%) tumors without blastic transformation, and 6 of 8 (75%) and 6 of 8 (75%) tumors with blastic transformation (defined as >50% blast cells). Correlation between GrB/TIA-1 expression in first diagnostic biopsies from patches or plaques from 40 patients with T2NoMo-stage MF and clinical follow-up data did not reveal differences in clinical behavior and survival between patients with (n = 14) or without (n = 26) expression of cytotoxic proteins, indicating that MF expressing cytotoxic proteins should not be considered as a separate group.

Antigens, CD↗
PubMed1985

Histologic assessment of lymph nodes in mycosis fungoides/Sézary syndrome (cutaneous T-cell lymphoma): clinical correlations and prognostic import of a new classification system.

Mycosis fungoides and the Sézary syndrome share common cutaneous histopathologic features, and this spectrum of malignant disease is referred to here as cutaneous T-cell lymphoma (CTCL). A method (LN classification) for describing the histopathologic features of lymph nodes in CTCL is presented. In this system, lymph node biopsy specimens are scored according to the number of atypical lymphoid cells in T-cell-dependent paracortical zones and the preservation or distortion of the lymph node architecture. Lymph node architecture is preserved in lymph nodes scored LN1 to LN3, and these nodes may have coexistent dermatopathic change. LN1 nodes have single infrequent atypical lymphocytes in paracortical T-cell regions. LN2 nodes have small clusters of paracortical atypical cells. LN3 nodes have large clusters of atypical cells. LN4 nodes are partially or totally effaced by atypical cells. This system was used to classify 96 lymph node biopsy specimens obtained within six months of the initial diagnosis of CTCL; no LN1 nodes, 37 LN2, 44 LN3, and 15 LN4 nodes were found. The LN class was significantly correlated with the extent of skin, blood, and visceral involvement, as well as with survival. Patients with LN2 lymph nodes have an estimated five-year survival of 70 per cent, while patients with LN3 and LN4 nodes have estimated five-year survivals of 30 and 15 per cent, respectively. The survival differences between the LN subgroups were all significant (P less than 0.05). The LN classification system was clearly shown to be reproducible among experienced pathologists. The LN system for the histopathologic classification of lymph nodes in CTCL is of prognostic value and should be used to assess lymph node biopsies in patients with CTCL.

Humans↗
PubMed1983

Treatment of cutaneous T-cell lymphoma (mycosis fungoides) with 13-cis-retinoic acid.

Four patients with refractory cutaneous T-cell lymphoma (mycosis fungoides) were treated with 13-cis-retinoic acid. Near complete clearing of extensive tumours and plaques was seen in one patient, who remains in partial remission with continued improvement after fifteen months. Two patients showed improvement in pruritus and 50% reduction in plaques by four and six weeks, respectively. The fourth patient had improvement in pruritus and clearing of plaques, but dryness and scaling necessitated reduction and eventually withdrawal of the treatment.

Adult↗
PubMed2006

[Mycosis fungoides of the eyelids. Two case reports].

Mycosis fungoides is a distinct variant of cutaneous T cell lymphoma. We describe two male patients presenting with the third stage of the disease at the age of 56 and 67 years. The patients had large, patchy pigmented tumors all over the face and eyelids. Incisional biopsy from the lid skin revealed full-thickness involvement of the dermis by malignant lymphocytes, angiotropism, and rare figures of epidermotropism. Immunohistochemical studies showed that these malignant lymphocytes expressed CD2, CD3, CD4, CD5, and CD8 antigens but were negative for CD7 antigen. Multiagent chemotherapy and PUVA treatment were administered with limited successful outcome on their cutaneous lesions. Both patients died from problems related to the progression of the systemic disease. These two cases demonstrate the poor prognosis of the tumor stage because of strong association with widespread systemic involvement and emphasize the need for early diagnosis.

Aged↗
PubMed1980

Cutaneous T cell lymphoma: mycosis fungoides, Sézary syndrome, and other variants.

Cutaneous T cell lymphoma (CTCL) is a clinically and immunologically defined neoplasm which encompasses epidermotropic (mycosis fungoides, Sézary syndrome) and nonepidermotropic variants. A natural evolution apparently occurs from the epidermotropic to the nonepidermotropic form. In this review, cellular properties of the neoplastic cells are correlated with specific clinical observations, and recent therapeutic advances are discussed. Advances in our understanding of the pathogenesis of CTCL, including preliminary evidence suggesting that keratinocytes may elaborate a hormonal substance capable of inducing T lymphocyte differentiation, are discussed.

Female↗
PubMed1981

An unusual and fatal case of disseminated cutaneous herpes simplex. Infection in a patient with cutaneous T cell lymphoma (mycosis fungoides).

A patient with plaque stage mycosis fungoides (MF) developed an atypical disseminated cutaneous herpes simplex virus (HSV) infection manifested by polycyclic cutaneous ulcers. Although Tzanck preparations and serial antibody titers to herpes virus were negative, the diagnosis was readily established by viral culture and histologic examination of the skin lesions. Following adenine arabinoside therapy, the viral cultures of the ulcers became negative and the spread of virus-induced ulcerations ceased. In an immunocompromised host with rapidly advancing, sharply punched-out polycyclic cutaneous ulcerations, herpes simplex infection should be considered even though the classical vesicular lesions are absent.

Female↗
PubMed1981

PUVA treatment of erythrodermic and plaque type mycosis fungoides.

Five patients with plaque type mycosis fungoides (MF) and five patients with erythrodermic MF responded favorably to oral psoralen photochemotherapy (PUVA). The mean total UVA irradiation dose was less for erythrodermic than for plaque type MF, but the mean number of treatments to achieve clearing was greater in the erythrodermic patients. Histologic examination at clearing revealed persistence of an inflammatory infiltrate in the lower dermis in most cases. Subsequent recurrent lesions in five patients revealed a more extensive dermal inflammatory infiltrate, although findings were not always diagnostic of MF due to a lack of epidermal involvement. Resumption of more intensive PUVA therapy again resulted in clinical clearing in all five patients. The follow-up period for six patients who received long-term PUVA maintenance ranged from 1 1/2 to 3 1/2 years. During PUVA therapy, five of ten patients developed epithelial malignancies or premalignancies, and one patient developed a malignant fibrous histiocytoma. Most of these patients had received prior treatment with electron beam and topical nitrogen mustard.

Adult↗
PubMed1982

Home ultraviolet phototherapy of early mycosis fungoides: preliminary observations.

Thirty-one patients with early mycosis fungoides (MF) and three patients with parapsoriasis en plaques were treated with ultraviolet phototherapy (280 to 350 nm) at home using a commercially available light source containing four Westinghouse FS40 lamps. A complete clinical and histologic remission of disease, lasting for a median duration in excess of 18 months, was achieved in nineteen patients (61%) with MF. Although higher complete response rates generally are achieved with other therapeutic modalities, ultraviolet phototherapy with its minimal adverse effects may be indicated for selected patients. Controlled studies are encouraged to evaluate the full potential of conventional phototherapy in the management of MF.

Adult↗
PubMed1982

Demonstration of OKT 6-reactive cells in mycosis fungoides.

Infiltrates of five cases of mycosis fungoides (MF) were studied for the presence of cells reactive with a monoclonal antibody, OKT 6, which detects an antigen present on relatively immature thymocytes and Langerhans cells. In situ immunohistochemical staining was used for their demonstration. OKT 6-reactive cells formed a definite component of the dermal infiltrates of all patients examined. In three patients who showed numerous Pautrier microabscesses on routine histologic examination, OKT 6-positive cells were found to form a component of these abscesses. OKT 6-reactive cells have also recently been shown to be present in varying numbers in the dermal infiltrates of large plaque (atrophic) parapsoriasis (LPAP), a condition which may terminate in MF. The significance of these findings is discussed.

Antibodies, Monoclonal↗
PubMed1982

In situ immunologic phenotyping of mycosis fungoides.

In situ immunologic phenotyping of the cutaneous lymphoid infiltrates of five cases of mycosis fungoides (MF) was performed. This was done by the immunoperoxidase technic using monoclonal antibodies directed against normally expressed by mature peripheral T cells and T cells subsets. A significant proportion of the infiltrates reacted with peripheral T cell antibodies. In addition, "helper" predominance was demonstrated. However, cells reacting positively with "suppressor" antibodies were also demonstrated in three cases, indicating immunologic heterogeneity of the infiltrates. The presence of a significant component of the infiltrates yielding an equivocal or negative reaction with the mature T cell antibodies, especially in the infiltrates of one case which had a fatal outcome, suggests further heterogeneity with the presence of immature cells. Future investigation with monoclonal antibodies directed against immature T cell differentiation antigens will be of interest.

Antibodies, Monoclonal↗
PubMed1983

Topical carmustine (BCNU) for mycosis fungoides and related disorders: a 10-year experience.

A 10-year experience in eighty-six patients confirms the effectiveness of topical carmustine (BCNU) in mycosis fungoides (MF). Complete remission (CR) was achieved in 84% of those with less than 10% involvement (stage IA), median CR, 12 months, and in 52% with greater than 10% involvement (stage IB), median CR, 23 months. The probability of freedom from relapse for 1 year was 72% in stage IA and 37% in stage IB. No deaths in stages IA or IB were attributable to MF. Including all causes of death, the probability of 5-year survival for stage IA was 93% and for stage IB, 48%. Good results were obtained with only local BCNU in fourteen patients with mostly less than 5% involvement. Five of seven with poikilodermatous MF, two with parapsoriasis en plaques (PEP), and three with lymphomatoid papulosis did well. Persistent local therapy cleared deeply infiltrated lesions in some patients. With present schedules, the hazard of bone marrow depression is slight. Erythematous reactions and telangiectasia are troublesome but have not been accompanied by premalignant changes.

Administration, Topical↗
PubMed1984

T cell subset heterogeneity in a series of patients with mycosis fungoides and Sézary syndrome.

The diagnostic value of the identification of T cell subsets in skin biopsies from a series of eight patients (clinical stages I-IV) with cutaneous T cell lymphoma (6 with mycosis fungoides and 2 with Sézary syndrome) was determined with an indirect immunoperoxidase technic using commercially available monoclonal anti-T lymphocyte antibodies. Each patient had a mixture of helper and suppressor T cells within both the dermis and the epidermis, although helper T cells predominated approximately 2:1 over suppressor cells in all except two patients. This pattern is not appreciably different from that reported in benign inflammatory dermatoses. One patient with Sézary syndrome who had had an unusually protracted course was found to have a greater number of suppressor cells than helper cells within the epidermis. We conclude that the in situ identification of T cell subsets adds little, if any, diagnostic sensitivity to standard histopathologic methods in cutaneous T cell lymphoma.

Aged↗
PubMed1984

Immunoperoxidase examination of cutaneous infiltrates of mycosis fungoides and large-plaque atrophic parapsoriasis with OKT10.

A monoclonal antibody (OKT10), which was developed recently, reacts with pro-thymocytes, T cell acute lymphoblastic leukemia (ALL) cells, cells in normal bone marrow (including plasma cells), and activated T cells. Tissues from patients with cutaneous T cell lymphoma were studied for the presence of OKT10-reactive cells with the use of an indirect immunoperoxidase technic. OKT10-reactive cells were identified in three of eight cases of mycosis fungoides, one of two cases of Sézary syndrome, with an equivocal reaction in one of ten cases of large-plaque parapsoriasis and in one of seven positive patch tests (allergic contact dermatitis). The biologic and possible clinical implications are discussed.

Antibodies, Monoclonal↗
PubMed1985

Intralesional interferon in the treatment of early mycosis fungoides.

Twelve patients with early mycosis fungoides were enrolled in a randomized, double-blind, placebo-controlled study. Isolated plaques were injected three times a week with recombinant alpha 2-interferon in nine patients and with the vehicle in three patients. Two additional plaques were evaluated in each patient; one was left untreated, and another was treated topically with either placebo ointment or betamethasone ointment. Biopsies were taken from an untreated, representative plaque prior to treatment and from all test sites following treatment for light microscopy and T lymphocyte subsets. Three of the nine lesions injected with interferon cleared, and all showed improvement. Thirteen of eighteen noninjected lesions improved in patients who received interferon, showing a systemic effect. In the control group, none of the injected lesions improved and only two of the noninjected lesions showed any change. Histopathologic changes confirmed the clinical impression. This study shows that intralesional interferon may be given safely and has a beneficial effect, both locally and systemically.

Adult↗
PubMed1985

Palmoplantar hyperkeratosis in mycosis fungoides.

The association of palmoplantar hyperkeratosis and mycosis fungoides (MF) has been described less frequently in the dermatologic literature. We present a patient with MF who developed hyperkeratosis of the palms and soles. Histologic examination of a specimen from the left palm showed microscopic changes of MF.

Humans↗
PubMed1986

Mycosis fungoides: evaluation of immunohistochemical criteria for the early diagnosis of the disease and differentiation between stages.

Lesional skin specimens from twenty-eight patients with mycosis fungoides were studied by evaluating immunohistochemical criteria, primarily with monoclonal antibodies. It was demonstrated that significant differences exist between the control and the premycotic-stage group in regard to the monoclonal antibodies BE1, BE2, and OKT9. The detection of specific antigenic determinants on the surface of cell populations early in the course of the disease seems to be of considerable value for the early diagnosis of the disease. Statistically significant differences were found between the premycotic stage and the plaque stage in regard to T lymphocytes, macrophages, OKT6+, OKT4+, OKT8+, and BE2+ cells in the dermal infiltrate. Significant differences were also shown between the plaque and tumorous groups, concerning macrophages, T cells, and OKT9+ cells in the dermis, as well as epidermal dendritic cells. Differences between stages may supplement histologic data for the follow-up of the disease with or without treatment.

Antibodies, Monoclonal↗