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November 1992

Xanthomatized Atypical T Cells in a Patient With Mycosis Fungoides and Hyperlipidemia

Author Affiliations


From the Departments of Dermatology (Drs Ross and Cobb) and Laboratory Medicine (Dr Rushin), National Naval Medical Center, the Laboratory of Pathology, Section of Hematopathology, National Institutes of Health (Dr Roman), and the Department of Dermatology, Uniformed Services University of the Health Sciences (Dr Friedman), Bethesda, Md.

Arch Dermatol. 1992;128(11):1499-1502. doi:10.1001/archderm.1992.01680210077011

• Background.—  Lipoprotein—T-cell interactions are being reported with increasing frequency, and there is evidence that lipoproteins play a role in immunoregulation. We describe a patient with mycosis fungoides and hyperlipidemia who developed xanthomatization in one preexisting plaque. The case is unique in that some of the lipidized cells were atypical T cells. In previously reported cases of mycosis fungoides with dystrophic xanthomatosis, the lipid-containing cells have been identified only as histiocytes.

Observations.—  Immunopathologic feautures, electron microscopy, and lipid stains of the xanthomatized plaque demonstrated that some of the lipid-laden cells were atypical T cells.

Conclusions.—  In mycosis fungoides, malignant T cells may be intimately involved in processing of tissue lipids. We suggest that low-density lipoprotein receptors on activated T cells facilitated the cytoplasmic lipidization in this case.(Arch Dermatol. 1992;128:1499-1502)

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