We report a patient with mycosis fungoides (MF) and transformation to anaplastic (CD30+) lymphoma, who developed an unusual manifestation in the breast. Cutaneous and extracutaneous tumour cells both showed marked intraepithelial migration, but had distinct expression patterns of epitheliotropism-associated integrins. Intraepidermal and dermal lymphoma cells in the skin expressed most of the integrins that are presumed to be involved in epitheliotropism, such as leucocyte functional antigen-1 (LFA-1), alpha 1 beta 1, alpha 3 beta 1, alpha 4 beta 1 and alpha 6 beta 1. In the breast, most of the extraepithelial tumour cells only expressed the laminin-5 ligand alpha 3 beta 1 (strong) and the collagen ligand alpha 1 beta 1 (weak). However, on the intraepithelial tumour cells in the mammary ducts and glands LFA-1, alpha 4 and alpha E could also be detected. In view of these findings we propose epitheliotropism of the MF cells in the breast to be a multistep process in which tumour cell-epithelial basement membrane (EBM) interaction, predominantly mediated by alpha 3 beta 1 and laminin-5, is the primary event. Adhesion to and subsequent infiltration of the neoplastic lymphoid cells into the EBM may, either directly or indirectly, lead to upregulation and/or activation of other integrins that amplify interaction with epithelial cells.

Since non-Hodgkin's lymphoma (NHL) cells interact with surrounding structures similarly to their normal counterparts, microenvironmental changes and the aberrant expression of adhesion molecules are considered to be of importance in lymphomagenesis, In this immunohistochemical study, the composition of several extracellular matrix (ECM) components and the expression of their beta 1 integrin receptors were examined in nodal and extranodal T-cell NHLs. Except for the T-lymphoblastic NHLs, almost all T-NHLs displayed abundant deposition of matrix and considerable expression of the alpha 4 and beta 1 integrin chains, This is in contrast to B-cell NHLs, which show ECM patterns comparable to those in reactive lymphoid tissue or, in cases of high-grade malignancy, active matrix degradation and very low expression or absence of beta 1 integrins, as previously described, This difference is probably based on distinct cytokine production in B- and T-cell malignancies, As in B-NHL, nodal and extranodal T-NHLS of the same morphological subtype exhibit identical ECM patterns, which suggests that malignant lymphoid cells of both B and T origin create at least part of their own specific micro-environment.

Laminins are a family of multifunctional basement membrane glycoproteins. Over the last years, many laminin isoforms have been characterized, which were shown to be composed of distinct combinations of variant alpha, beta and gamma chains. Some of these isoforms show remarkable tissue specificity, which suggests functional involvement in local processes. In this study the previously described mAb 4C7, which recognize epithelial basement membranes as well as endothelial basement membranes in lymphoid follicles, was identified as an anti-laminin-5 antibody. Using a set of mAbs against various variant laminin chains we established that specifically the gamma 2 chain of laminin-5 was confined to the endothelial basement membranes of vessels in lymphoid follicles, whereas other variant laminin chains were also expressed elsewhere in the lymphoid follicles, whereas other variant laminin chains were also expressed elsewhere in the lymphoid tissue. Additionally, the expression of the known integrin receptors of laminin-5 was also examined. The alpha 6 beta 4 integrin-receptor for laminin was found to be colocalized with the laminin-5 gamma 2 chain on the abluminal surface of endothelial cells, whereas the alpha 3 integrin chain could not be detected in lymphoid follicles. This finding suggests that the alpha 6 beta 4 integrin (and not the alpha 3 beta 1 integrin) serves as a laminin-5 receptor on endothelial cells in the follicular compartment of lymphoid tissue. Furthermore, alpha 6 beta 4 was also found in the same punctuated pattern on FDCs as laminin-5. The function of the laminin-alpha 6 beta 4 complex in this particular localisation is still obscure, but a role in the maintainance of the follicular compartment via hemidesmosome-like attachment sites is postulated.

Intraepithelial migration of lymphoid cells (epitheliotropism) is a biological process that can be observed under various physiological and pathological conditions. Recently, epitheliotropism was proposed to be a multi‐step process, involving interactions of lymphoid cells with both epithelial basement membrane (EBM) and epithelial cells. In the present study we analysed by immunohistochemistry the adhesion mechanisms that are potentially involved in epitheliotropism of lymphoid cells in various disorders, such as tonsillar hyperplasia, coeliac disease, malignant lymphomas of mucosa‐associated lymphoid tissue (MALTomas), and mycosis fungoides (MF). The combinations of adhesion molecules expressed on the participating lymphoid and epithelial cells varied among these disorders. These findings suggest the adhesion pathways utilized in epitheliotropism may be associated with the nature of the lymphoid cell (reactive or neoplastic/B or T) and/or the site of the epithelium involved. In some cases the specificity of the process was determined by the adhesion mechanism involved in the lymphocyte–EBM interaction, as in the case of α3β1 integrin/laminin‐5 in MF, and in others by the adhesion mechanisms involved in the interaction between lymphoid and epithelial cells, such as α4 integrin/VCAM‐1 in tonsillar hyperplasia and αEβ7/E‐cadherin in coeliac disease.

In this study the distribution patterns of various extracellular matrix components and their receptors (i.e. beta 1 integrins) in B-cell non-Hodgkin lymphomas were examined and compared to those in reactive lymphoid tissue. Neoplastic follicles within follicular lymphomas showed similar patterns to that observed in reactive follicles, which appeared to be strongly associated with the presence of follicular dendritic cells. Diffuse lymphomas of low and intermediate malignancy grade revealed features comparable to those of interfollicular areas of reactive lymphoid tissue, irrespective to which compartment the tumour cells were related. Highly malignant lymphomas, however, displayed unique extracellular matrix configurations, resulting from active matrix degradation by macrophages; this may support rapid tumour growth. Extranodal lymphomas showed virtually the same matrix patterns as their nodal counterparts, suggesting that (malignant) lymphoid cells generate (at least partly) their own specific microenvironment. In reactive lymphoid tissue beta 1 integrins were mainly found on resident cells and except for alpha 4, alpha 5 (and beta 1) the lymphoid cells expressed very little, if any, beta 1 integrins. In comparison, expression of these integrins on lymphoma cells was reduced (follicular lymphomas) or could not be detected at all (diffusely growing lymphomas); this might contribute to the growth pattern and metastatic properties of the tumours.