Evaluation of acid alpha-naphthyl acetate esterase activity as a marker of T lymphocytes in benign and neoplastic cutaneous infiltrates

In situ study of T-cell subpopulations in cutaneous T-cell lymphoma. Diagnostic criteria

The T-cell subpopulations present in skin biopsy specimens from 91 patients with cutaneous T-cell lymphoma (CTCL) and from 19 patients with benign lymphocytic infiltrates of the skin were examined in situ to define criteria for the differentiation of benign from malignant lymphocytic infiltrates. The monoclonal antibodies OKT 1 (pan T-cell), BE 3 (pan T-cell), OKT 4 (helper/inducer T-cell), OKT 6 (cortical thymocyte and Langerhans' cell), OKT 8 (suppressor T-cell), and OKT 10 (pan thymocyte) were used in direct or indirect immunoperoxidase reactions. Sections were examined at high magnification, and the distribution and percentage of cells reactive with each antibody were assessed. Three main patterns of staining were observed in the CTCL patients: (1) 64% of the biopsy specimens showed that 60% of the cells present in the dermis were T-cells that were OKT 1+ and BE 3+ and there was an even distribution of the different T-cell subpopulations, with 54% being OKT 4+ and 8% OKT 8+; (2) 21% patients showed selective loss of OKT 1 antigen, and 80% of these also showed loss of BE 3 antigen; and (3) 15% patients showed large numbers of OKT 8+ cells (range, 50%-90%) but the percentages of OKT 1+ and OKT 4+ cells were within the ranges seen in Group 1, indicating the presence of a population of T-cells simultaneously expressing OKT 4 (helper/inducer) and OKT 8 (suppressor) reactivity. In 95% of the CTCL patients, 3.5% OKT 6+ cells were present in the dermal infiltrate, and in 92% of patients, 3% OKT 10+ cells were present. Comparing sections from CTCL and benign dermatoses, no single diagnostic feature was identified, but helpful differentiating features were: (1) the even, rather than nodular, distribution of the T-cell subpopulation; (2) the selective loss of OKT 1 and BE 3 antigens; (3) the presence of T-cells simultaneously expressing OKT 4 and OKT 8 antigens; and (4) the presence of OKT 10+ cells.

Gastrointestinal complications of mycosis fungoides

Mycosis fungoides (MF) is an uncommon T-cell lymphoma which characteristically involves the skin. Two patients with MF are described who developed fatal complications secondary to involvement of the gastrointestinal tract. One developed malabsorption due to small intestinal involvement; the other had a massive haemorrhage from an ulcerated nodule of tumour in the stomach. The potential for extracutaneous spread is discussed, and it is emphasized that bowel infiltration should be considered in any patient with MF who develops gastrointestinal symptoms or complications.

Demonstration of T lymphocytes in leprous granuloma using the acid alpha naphtyl acetate esterase activity. An attempt at quantitative analysis

In nine leprosy patients (1 TT, 1 BT, 4 BL and 3 LLp), esterase positive lymphocytes (T Lymphocytes) were studied in frozen sections of skin biopsies by alpha naphtyl acetate esterase pH 5.8 method (ANAE) Four patients had never been treated previously and five patients exhibited clinical and bacteriological evidence of relapse for inadequate therapy at first biopsy. There was an increase in ANAE (+) lymphocyte density in granulomas when second biopsies were done after efficient treatment, evaluated by bacillary index for the eight bacilliferous patients, and clinical improvement. The significance of T cells in granulomas is discussed.

Demonstration of histiocytes in the epidermal infiltrate of mycosis fungoides

The presence of histiocytes in the epidermal and dermal infiltrate of mycosis fungoides was observed histochemically by revealing a diffuse pattern of acid alpha-naphthyl acetate esterase (ANAE) activity in the cytoplasm, and immunohistochemically by demonstrating the presence of histiocyte-specific 'enzymes', lysozyme, alpha-I-antitrypsin and alpha-I-antichymotrypsin. Histiocytes in the infiltrate of mycosis fungoides may be involved in antigen processing and interaction with T lymphocytes.

In-situ T lymphocyte identification in cutaneous tissue sections of benign and malignant dermatoses

An indirect immunoperoxidase technique employing a specific anti-human T lymphocyte antiserum has been used to identify T lymphocytes in cutaneous tissue sections of various benign and malignant dermatoses. Skin biopsies from patients with histologically confirmed lichen planus, discoid lupus erythematosus, psoriasis, actinic keratosis, squamous cell carcinoma, Bowen's disease, keratoacanthoma, malignant melanoma, inflamed serborrhoeic warts, sarcoidosis, follicular lymphoma and multicentric reticulohistiocytosis were examined. T lymphocytes were found to be the predominant cell type in the cutaneous infiltrates of the majority of these dermatoses. However, only few T lymphocytes were identified in sarcoidosis where they tended to be restricted to the periphery of the epithelioid cell granulomas. Similarly, in the cutaneous infiltrates of follicular lymphoma and in a patient with multicentric reticulohistiocytosis, few T lymphocytes were identified.