Quantitative analysis of lymphoid cells in myocosis fungoides, Sézary's syndrome and parapsoriasis en plaques.

Semi-thin sections are superior to paraffin sections for differentiating lymphoid cells. To test their possible significance in the diagnosis of cutaneous T-cell lymphomas, the following investigation was made: A quantitative analysis of lymphoid cells in the cellular infiltrate of cutaneous lesions of mycosis fungoides (11 cases), Sézary's syndrome (9 cases), and parapsoriasis en plaques (14 cases) was made using semi-thin sections of epon-embedded biopsies. As controls biopsies of patch test reactions, contact dermatitis, initial psoriasis, and erythema chronicum migrans were studied. A high percentage of Lutzner (Sézary) cells was consistently found in Sézary's syndrome and occasionally in parapsoriasis en plaques only. In mycosis fungoides lymphocytoid cells with the nuclei less dense than in normal lymphocytes were predominant. In most tumorous lesions of mycosis fungoides and of Sézary's syndrome an increased percentage of immunoblasts was noted. Normal lymphocytes were the most frequent cell type in parapsoriasis en plaques as well as in the controls. These findings may prove helpful in the diagnosis of problem cases, for which the use of semi-thin sections is recommended.