Immunohistochemistry

Several phenotypes of neoplastic lymphocytes in PR have been reported. The neoplastic cells in PR may express CD4, CD8 or be CD4/CD8 double negative. Most cases of PR express a T helper phenotype: CD3+, CD4+, CD5+, CD8- (8). There are reports on CD8+ cases (5,9) or PR expressing a gamma/delta phenotype (10). The neoplastic cells demonstrate a higher proliferation rate (>30%) in comparison to lymphocytes in the patch or plaque stage MF (<10%). Lastly, in some cases, infiltrates in PR may contain high numbers (>50%) of CD30+ cells, whereas such CD30 reactivity is never observed in nontransformed MF (5,11). Loss of leukocyte common antigen (CD45) on tumor cells was only found in the localized form of PR (12). Only about 10% of tumor cells show proliferative activity (13).

Neoplastic cells in PR strongly express cutaneous lymphocyte antigen, a skin-homing receptor interacting with E-selectin on cutaneous endothelial cells. In addition, tumor cells express the adhesion molecule alpha E beta 7, which interacts with E-cadherin on keratinocytes. These data may explain the pronounced epider-motropism of neoplastic lymphocytes in PR (14).

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