Pathogenesis of cutaneous T-cell lymphoma

Cutaneous T-cell lymphoma is a malignant disease whose behavior reflects its T-cell lineage. The biologic characteristics of the disease are understandable when viewed from a perspective of normal T-cell-skin interactions. Thus, it is of no surprise that this malignancy of helper T lymphocytes usually demonstrates a remarkable affinity for the skin at the outset and that, coincident with decreased dependence upon this unique environment, the extent and aggressiveness of disease increases. Although the inciting event responsible for the development of cutaneous T-cell lymphoma is unknown, a mechanism for local growth and distant expansion of malignant cells has been postulated in terms of IL-2-dependent and -independent growth phases. As our vision into the cellular and subcellular workings of this malignancy becomes more acute, specific therapeutic and preventive measures will emerge.