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Brian A. Brigham, MB, BS, MRCP; Paul A. Bunn, Jr, MD; John E. Horton, DMD; Geraldine P. Schechter, MD; Larry M. Wahl, PhD; Edward C. Bradley, MD; N. Reed Dunnick, MD; Mary J. Matthews, MD

Arch Dermatol. 1982;118(7):461-467.

Abstract
• The clinical course of three patients with cutaneous T-cell lymphoma (CTCL) in whom skeletal disease developed is presented and the literature on skeletal involvement in these disorders is reviewed. Three separate types of skeletal manifestations occurred: (1) osteolytic lesions, (2) osteoblastic lesions, and (3) diffuse osteoporosis. Hypercalcemia was present in two cases. Tumor cells from two patients in short-term culture secreted osteoclast-activating factor(s). Both of these patients had pathologic evidence of osteoclast activation in bone sections. Thus, the tumor cells in certain patients with CTCL may derive from a monoclonal proliferation of a T-cell subset capable of producing humoral bone-resorbing factor(s) similar to those demonstrated in cultures of mitogen- and antigen-activated normal lymphocytes. Since skeletal lesions are unusual, it would follow that other T-cell subsets account for pathologic cell proliferation in most patients with CTCL.

(Arch Dermatol 1982;118:461-467)

Author Affiliations
From the National Cancer Institute-Veterans Administration Medical Oncology Branch, National Cancer Institute and the VA (Drs Brigham, Bunn, Bradley, and Matthews), and the Hematology Section, Medical Service, VA Medical Center and George Washington University School of Medicine (Dr Schechter), Washington, DC; the Department of Periodontology, Harvard School of Dental Medicine, Harvard University, Boston (Dr Horton); and the Laboratory of Microbiology and Immunology (Dr Wahl) and the Diagnostic Radiology Department, Clinical Center (Dr Dunnick), National Institutes of Health, Bethesda, Md.

Footnotes
Accepted for publication Aug 18, 1981.

Reprint requests to NCI-Navy Medical Oncology Branch, National Naval Medical Center, Bethesda, MD 20814 (Dr Bunn).

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