Immunophenotypic studies in cutaneous T-cell lymphomas: clinical implications.

Examination of biopsies from 62 patients with, or suspected of having cutaneous T-cell lymphoma (CTCL) revealed 24 cases in which the neoplastic cells expressed aberrant or suppressor T-cell phenotypes. The clinical records of these patients were reviewed in an attempt to establish whether recognition of these phenotypes has any clinical implications. Twelve patients had mycosis fungoides (MF) with plaques (n = 4) or tumours (n = 8), four had Sézary syndrome, and eight had large-cell lymphomas of pleomorphic (n = 6) or anaplastic subtype (n = 2). Most of the large-cell lymphomas behaved aggressively, as might have been expected from their cytological appearance. Aggressive courses were also seen in Sézary syndrome, and in tumour lesions of MF, whereas the behaviour in cases of plaque lesions was indolent. Again, this might have been anticipated from the clinical staging and routine histological examination. It is suggested that the expression of aberrant or suppressor T-cell phenotypes in CTCL is not of independent prognostic significance, but that the stage and histology are more important. This issue is an important topic for a prospective analysis.