Spatial distribution of Langerhans' cells and T-lymphocyte subpopulations in human tympanic membrane and aural cholesteatoma.

Immunohistochemical analysis of human cholesteatoma matrices revealed the presence of Langerhans' cells and T-lymphocytes. Through cell-to-cell interaction, Langerhans' cells probably play a key role in skin-related disorders, including cholesteatomas. They probably originate from a mobile cell population of monocyte origin and migrate into and out of the body's lining. Their custodial function is often carried out in close relation with T-lymphocytes. Monoclonal antibodies against Langerhans' cells and T-lymphocyte membrane receptors reveal the presence of these cell populations in cholesteatoma matrices but not in the tympanic membrane. Langerhans' cells and T-cell "traffic" through cholesteatomas are discussed in relation to the pathogenesis, natural course and recurrence of cholesteatomas. Through immunopathologic evaluation the clinical aggressiveness of a cholesteatoma may become predictable. It may even have consequences for the future handling of cholesteatomas.