THE SAME DOMINANT T-CELL CLONE IS PRESENT IN MULTIPLE REGRESSING SKIN-LESIONS AND ASSOCIATED T-CELL LYMPHOMAS OF PATIENTS WITH LYMPHOMATOIDPAPULOSIS

This study was undertaken to determine the clonality of lymphomatoid p apulosis (LyP), its clonal relationship to lymphomas, which occur at h igh frequency in LyP patients, and to define the cell lineage of Reed- Sternberg-like cells in type A lesions of LyP, Punch biopsies of skin of 11 adult patients with LyP were analyzed for morphologic subtype of LyP, surface antigens, and clonal T-cell receptor (TCR) gene rearrang ements, Clonal rearrangements were identified by semiquantitative poly merase chain reaction amplification and sequencing of TCR-beta chain g enes in nine patients and TCR-gamma chain genes in two patients. A sin gle dominant clone was detected in multiple separate LyP lesions, ofte n of different histologies, in nine patients. The same clone was detec ted in LyP lesions and the anaplastic large cell lymphoma (ALCL) of 2 patients and the mycosis fungoides (MF) of 2 other patients, No domina nt clone could be detected in one patient with LyP uncomplicated by ly mphoma or in a second patient with LyP and MF. A T-cell lineage was ev ident for RS-like cells in cell culture and in type A lesions. These r esults show that multiple regressing skin lesions and associated T cel l lymphomas (MF and ALCL) are clonally related in most LyP patients, w hich suggests that the disease in these patients was initiated by a no n-random genetic event.