RELAPSING ORAL AND COLONIC ULCERS WITH MONOCLONAL T-CELL INFILTRATION- A LOW-GRADE MUCOSAL T-LYMPHOPROLIFERATIVE DISEASE OF THE DIGESTIVE-TRACT

Background. Some cutaneous T-cell lymphoproliferative diseases (LPD), such as lymphomatoid papulosis and pityriasis lichenoides et variolifo rmis acuta, are characterized by an indolent or waning and waxing clin ical course. However, such T-cell LPD are rarely documented in other o rgans. Methods. A patient with T-cell LPD of the digestive tract chara cterized by repetitive episodes of self-healing ulcers in the oral and intestinal mucosa over the course of 17 years is reported. Biopsy spe cimens from oral and intestinal mucosa were studied by conventional pa thology, immunocytochemistry, and Southern blot analysis of T-cell rec eptor (TCR)-beta and -gamma gene rearrangement.Results. Immunocytochem ically, the infiltrating lymphocytes were lamina propria T cells with a dominant phenotype CD3+, CD4+/-, CD8-, and HML-1-. DNA study reveale d the same rearranged configuration of TCR-beta and -gamma genes in sp ecimens from both oral and colonic lesions. Conclusions. The present c ase may represent a novel T-cell lymphoproliferative disease (i.e., a digestive-tract mucosal counterpart of cutaneous dysplastic LPD).