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The lymph node in mycosis fungoides a light microscopic and electron microscopic and immunohistological study supporting the langerhans cell retrovirus

, : The lymph node in mycosis fungoides a light microscopic and electron microscopic and immunohistological study supporting the langerhans cell retrovirus. Histopathology (Oxford) 9(6): 587-622

The light microscopy, EM and monoclonal antibody findings in the lymph nodes of 9 patients with mycosis fungoides are described. Four cases showed dermatopathic change characterized by close association between small convoluted T4 lymphocytes and T6 antigen-presenting cells (Langerhans' and indeterminate dendritic cells) in the sinuses and paracortical zones. The T4:T8 ratio was between 3 and 5:1. One case showed dermatopathic change but included large convoluted T4 lymphocytes and occasional T10 lymphocytes. The T4:T8 ratio was 4:1. The antigen-presenting cells were mostly T6 negative (interdigitating reticulum cells). One case showed extensive paracortical expansion by small and large convoluted T4 lymphocytes. The T4:T8 ratio was 20:1. Few B lymphocytes and antigen-presenting cells were present. Two cases showed partial and one case total effacement by atypical lymphoid tissue. This included small and large convoluted T4 lymphocytes and T4 immunoblasts. The T4:T8 ratios were between 30 and 40:1. The changes in their antigen-presenting cell population were complex. Langerthans' cells in one case generally failed to express T6 antigen and in 2 displayed histiocyte features. In one case, both immature and budding type C retrovirus-like particles were identified in Langerhans cells. One extracellular mature type C virus-like particle was identified in another case. No ultrastructural distinction could be made between similarly sized primary lysosomes and possible intracytoplasmic mature type C retrovirus particles. These findings support the hypothesis that mycosis fungoides may represent an altered dermatonodal cycle resulting from an interaction between retrovirus. Langerhans' cells and lymphocytes.

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