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Our laboratory has previously identified a soluble factor derived from head and neck squamous cell carcinoma that impairs lymphocyte proliferative responses in vitro. This study further investigates the nature of the interaction between these factors and T lymphocytes. The proliferative activity of phytohemagglutinin-stimulated peripheral blood lymphocytes and the Jurkat T-cell line was significantly suppressed (>50%) by the supernatants of 13 (41.9%) of 31 recently explanted head and neck squamous cell carcinoma samples. A characteristic morphologic appearance of these suppressed cells and ladderlike pattern of DNA fragmentation on gel electrophoresis indicated that the suppressive supernatants were inducing or predisposing T cells to apoptotic death. This apoptosis-inducing activity may be similar to that previously described in a suppressive supernatant obtained from an esophageal carcinoma cell line. These results shed further light on the mechanism behind a soluble immunosuppressive factor or factors produced by head and neck squamous cell carcinoma.

Cell suspensions from six Warthin's tumors (WTs) were characterized with fluorescence-labeled cell cytometry. WT lymphocyte subsets were identified with monoclonal antibodies directed against lymphocyte-associated cell antigens including T lymphocyte subsets, B lymphocytes, and natural killer (NK) cells. Results showed that T cell proportions were 58% and B cell proportions were 39%. The T cell helper:cytotoxic-suppressor ratio was 5.7:1 and the B to T cell ratio was 0.8:1. NK cells represented 1.3% of cells. When compared to peripheral blood lymphocytes (PBLs) in the same patients, statistically significant differences were noted between PBLs and WT lymphocytes in the percentage of B lymphocytes (P < .01), T cytotoxic-suppressor lymphocytes (P < .02), NK cells (P < .01), and in the ratios of B to T lymphocytes (P < .01) and T helper to T cytotoxic-suppressor lymphocytes (P < .03). Comparing these data to retrospective data on lymphocyte distribution in normal and reactive lymph nodes, the epithelial component does not appear to exert a local effect on the lymphoid component of WT.

Metastatic mucosal melanoma is extremely rare. Only 0.6% to 9.3% of patients with cutaneous malignant melanoma will have metastases to the mucosa of the upper aerodigestive tract. The records of all patients with mucosal melanoma of the head and neck at the University of California, Los Angeles Medical Center during the past 30 years were reviewed. Patients with primary tumors were separated form those with metastatic involvement from a cutaneous primary site. These two groups were compared for differences in clinical symptoms, histopathologic findings, treatment, and survival characteristics. Frequent sites of metastatic involvement included the base of tongue and nasal cavity. These arose from a variety of cutaneous sites including the trunk and extremities and, in most instances, did not arise until 2 to 7 years after the initial cutaneous lesion. Most of those with metastases to the head and neck mucosa had disseminated disease. The histopathologic distinction between the two groups is described with photomicrographs. Junctional activity in the overlying or adjacent mucosa distinguishes primary mucosal melanoma from metastatic disease, in which the overlying mucosa is usually intact. This difference is useful in determining workup and treatment options. Aggressive surgical resection is suggested in treatment of primary melanomas, whereas surgery is at best palliative in those with metastatic disease.