Electron microscopic identification of Langerhans cells in the dermal infiltrates of mycosis fungoides.

The importance of the physical interaction between epidermal Langerhans cells and malignant cells in mycosis fungoides (MF) has been stressed recently. To further evaluate this concept, electron microscopic study was carried out to identify whether or not Langerhans cells are also present in the dermal infiltrates of MF. The cells with characteristic Langerhans cell-granules were found in the dermal infiltrates, from early patch to tumor lesions of MF. No vacuolous change suggestive of cell degeneration was found in these cells. These Langerhans cells revealed only a small number of specific granules, and nuclear cleavage and chromatin pattern similar to those of malignant lymphoid cells, thus hardly differentiating 2 cell types in a low power view. Similar to epidermal MF lesions, however, a close apposition of dermal Langerhans cells with malignant lymphoid cells was seen. In one occasion, one Langerhans cell was present at the epidermodermal junction, appearing as being in the process of crossing over the basal lamina. Inasmuch as malignant cells in MF have been shown to possess the functional properties of helper T cells and receptors for Ia (immune associated antigen), expressed in the epidermis solely on Langerhans cells, our findings may further suggest that these malignant T cells bind to Langerhans cells through a "lock and key" mechanism involving membrane-bound Ia.