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

¹ Institute of Pathology, University of Ancona, School of Medicine, Azienda Ospedaliera Umberto I-Torrette, 60020 Ancona, Italy
² Department of Haematology, University of Ancona, School of Medicine, Azienda Ospedaliera Umberto I-Torrette

Correspondence to:
Dr G Goteri, Istituto di Anatomia Patologica, Università degli Studi di Ancona, Azienda Ospedaliera Torrette di Ancona, Via Conca, 60020 Ancona, Italy;
g.goteri{at}ao-umbertoprimo.marche.it Background/Aims: CD8+ T cells and epidermal/dermal dendritic cells expressing CD1a are found among neoplastic CD4+ T cells in mycosis fungoides (MF) lesions. This study analysed the relation of CD8+ tumour infiltrating lymphocytes (TILs), CD1a+ epidermal Langerhan’s cells (LCs), and dermal dendritic cells (DDCs) to clinicopathological parameters in 46 MF cases.

Methods: Pretreatment diagnostic biopsy specimens of 46 MF cases were submitted to histological analysis and immunohistochemistry. Four histological grades were defined based on the density of the neoplastic infiltrate: grade 1 (mild superficial perivascular infiltrate), grade 2 (moderate superficial perivascular infiltrate with some tendency to confluence), grade 3 (pronounced superficial band-like infiltrate), and grade 4 (deep nodular infiltrate). Epidermotropism was scored as low, moderate, or high. Numbers of CD8+ T cells and of dermal and epidermal CD1a+ cells were scored as 1 (low), 2 (moderate), and 3 (high). Correlations between these parameters and clinical data (age, sex, clinical type of lesions, stage, response to treatment, and recurrence) were analysed by the ² test.

Results: Numbers of TILs and DDCs were associated with subepidermal infiltrates, being lower in less dense infiltrates, whereas there was no association between epidermal CD1a+ cells and the analysed parameters. Complete remission in treated patients was related to subepidermal infiltrates but not to TILs, LCs, or DDCs.

Conclusions: These results support the notion that CD8+ cells and dermal CD1a+ cells are active against tumour cells. MF with low numbers of TILs could represent an early stage of the disease, before TILs are activated against tumour specific antigens.

Keywords: mycosis fungoides; immunophenotype; Langerhan’s cells; dermal dendritic cells; CD8+ cells

Abbreviations: CR, complete remission; DDC, dermal dendritic cell; LC, Langerhan’s cell; MF, mycosis fungoides; TCR, T cell receptor; TIL, tumour infiltrating lymphocyte

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