Sézary syndrome. A clinicopathologic study of 39 cases

The histopathologic and clinicopathologic characteristics of 121 skin biopsy specimens from 39 patients with Sézary syndrome were reviewed. The most frequently noted histologic type was a lymphomatoid subepidermal band infiltrate, composed predominantly of atypical lymphoid cells with cerebriform nuclei, found in 53 (44%) of the skin biopsy specimens. A lymphocytic band infiltrate, characterized by a predominance of small lymphocytes and a variable admixture of atypical lymphoid cells, was found in 47 (39%) of the specimens. Only 18 (15%) of the lymphomatoid band specimens from ten patients demonstrated epidermal involvement suggesting mycosis fungoides. Twenty-one (17%) of the biopsy specimens were interpreted as showing changes consistent with those of chronic dermatitis. Despite multiple skin biopsy specimens, there was a weak association noted between the histologic patterns and the clinical stage of disease or the prognosis.