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Xanthomatized atypical T cells in a patient with mycosis fungoides and hyperlipidemia
E V Ross1, L Roman, J M Rushin
1Department of Dermatology, National Naval Medical Center, Bethesda, Md.
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 features, 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.
Insights
In mycosis fungoides, malignant T cells can process tissue lipids, a finding supported by a unique patient case. This suggests low-density lipoprotein receptors on T cells may drive lipid accumulation.
Area of Science:
- Immunodermatology
- Cellular lipid metabolism
Background:
- Lipoprotein-T-cell interactions are increasingly recognized for their role in immunoregulation.
- Mycosis fungoides (MF) is a type of T-cell lymphoma.
- Hyperlipidemia is a condition characterized by high levels of lipids in the blood.
Observation:
- A patient with mycosis fungoides and hyperlipidemia developed xanthomatization within a preexisting plaque.
- Histopathological analysis revealed that lipid-laden cells within the xanthomatized plaque were atypical T cells, unlike in previous cases where only histiocytes were identified.
Findings:
- Immunopathologic features, electron microscopy, and lipid stains confirmed that atypical T cells were involved in lipid processing.
- This case is unique as it demonstrates malignant T cells, not just histiocytes, accumulating lipids.
Implications:
- Malignant T cells in mycosis fungoides may actively participate in the processing and accumulation of tissue lipids.
- Low-density lipoprotein receptors on activated T cells are suggested as a mechanism facilitating cytoplasmic lipidization in this context.