Mycosis fungoides--a disease of antigen persistence.

Abstract

The function of B- and T-lymphocytes in nineteen patients with classical Alibert's mycosis fungoides (MF) was studied. In general there was no evidence of immune depression, not even in those with the disease for many years. The distribution of B-cells in the peripheral blood was normal. No immunoglobulin- bearing lymphocytes were detected in freshly liberated cells from the skin lesions or on direct immunofluorescence microscopy of those lesions. Serum IgE levels were significantly elevated, even though only two of the patients were atopic. ‘Auto-antibodies’ were detected in thirteen patients. Two cases of malignant lymphoma and one of Sézary syndrome contrasted strikingly with the mycosis fungoides (MF) group. Our findings support the hypothesis that mycosis fungoides (MF) is a chronic granulomatous response to persistent unidentified antigen(s), upon which immune imbalance can develop resulting in ‘auto-immune’ phenomena and, in a few cases, the emergence of various lymphoreticular neoplasms.