Mycosis fungoides with extracutaneous localization in the breast.
We report a patient with mycosis fungoides (MF) and transformation to anaplastic (CD30+) lymphoma, who developed an unusual manifestation in the breast. Cutaneous and extracutaneous tumour cells both showed marked intraepithelial migration, but had distinct expression patterns of epitheliotropism-associated integrins. Intraepidermal and dermal lymphoma cells in the skin expressed most of the integrins that are presumed to be involved in epitheliotropism, such as leucocyte functional antigen-1 (LFA-1), alpha 1 beta 1, alpha 3 beta 1, alpha 4 beta 1 and alpha 6 beta 1. In the breast, most of the extraepithelial tumour cells only expressed the laminin-5 ligand alpha 3 beta 1 (strong) and the collagen ligand alpha 1 beta 1 (weak). However, on the intraepithelial tumour cells in the mammary ducts and glands LFA-1, alpha 4 and alpha E could also be detected. In view of these findings we propose epitheliotropism of the MF cells in the breast to be a multistep process in which tumour cell-epithelial basement membrane (EBM) interaction, predominantly mediated by alpha 3 beta 1 and laminin-5, is the primary event. Adhesion to and subsequent infiltration of the neoplastic lymphoid cells into the EBM may, either directly or indirectly, lead to upregulation and/or activation of other integrins that amplify interaction with epithelial cells.
Jaspars
L H
LH
Department of Pathology, Free University Hospital, Amsterdam, Netherlands.
Bonnet
P
P
Willemze
R
R
Meijer
C J
CJ
D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D016023:Integrins / Q000032:analysis; D017728:Lymphoma, Large-Cell, Anaplastic / Q000473:pathology; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000737:chemistry / Q000473:pathology*; D009363:Neoplasm Proteins / Q000032:analysis; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology*
D016023:Integrins; D009363:Neoplasm Proteins