The influence of the coexpression of CD4 and CD8 in cutaneous lesions on prognosis of mycosis fungoides: a preliminary study.

Sergio Umberto De Marchi,Serena Bonin,Giuseppe Stinco,Enzo Errichetti,Nicola Di Meo,Giusto Trevisan

doi:10.1155/2014/624143

Abstract

Background. Although techniques of immunophenotyping have been successful in characterizing the cells in the cutaneous infiltrates of mycosis fungoides little evidence suggests that variations in the phenotypic characterization correlate with prognosis. Objectives. In a preliminary prospective, single-centre, study we correlated the T-cell phenotype in cutaneous biopsies with the progression of the disease to determine whether the coexpression of CD4 and CD8 has an impact on prognosis. Methods. Skin biopsy specimens from 30 newly diagnosed patients were stained with immunoperoxidase techniques to determine their phenotypic characteristics. After a median followup of 42 months patients were divided into two groups with stable and progressive disease. Results. Eighteen patients had the conventional CD4+CD8− T-cell phenotype. Ten patients showed the coexpression of CD4 and CD8 and had a slightly lower rate of progressive disease. Conclusions. The coexpression of CD4 and CD8 in cutaneous lesions is not rare and is associated with a slightly lower rate of progressive disease. Since double positive CD4/CD8 phenotype is rarely reported in mycosis fungoides the presence on conventional immunophenotyping of both CD may be due to a “mixture” of neoplastic cells and inflammatory CD8+ tumor infiltrating lymphocytes. Immunohistochemical study combined with confocal microscopy could clarify this issue.

Highlights

Mycosis fungoides (MF) represents the prototype of cutaneous T-cell lymphoma, which is defined as clonal expansion of skin-homing T lymphocytes [1]
Techniques of immunophenotyping have been successful in characterizing the cells in the cutaneous infiltrates of mycosis fungoides little evidence suggests that variations in the phenotypic characterization correlate with prognosis
Single-centre, study we correlated the T-cell phenotype in cutaneous biopsies with the progression of the disease to determine whether the coexpression of CD4 and CD8 has an impact on prognosis

Summary

Introduction

Mycosis fungoides (MF) represents the prototype of cutaneous T-cell lymphoma, which is defined as clonal expansion of skin-homing T lymphocytes [1]. The disease begins with lightly erythematous patches that subsequently evolve into well-demarcated scaling plaques These plaques may progress to tumor lesions and subsequently spread to the viscera, but this progression is not necessarily seen in all patients [2]. Single-centre, study we correlated the T-cell phenotype in cutaneous biopsies with the progression of the disease to determine whether the coexpression of CD4 and CD8 has an impact on prognosis. The coexpression of CD4 and CD8 in cutaneous lesions is not rare and is associated with a slightly lower rate of progressive disease. Since double positive CD4/CD8 phenotype is rarely reported in mycosis fungoides the presence on conventional immunophenotyping of both CD may be due to a “mixture” of neoplastic cells and inflammatory CD8+ tumor infiltrating lymphocytes. Immunohistochemical study combined with confocal microscopy could clarify this issue

Methods

Results

Conclusion