Biomedical subjects
Publications and source records attributed to F R Davey.
A nodular, poorly differentiated lymphocytic lymphoma involving lymph nodes, spleen, and skin is reported in a 60-year-old man. The clinical course of this disorder strongly implied cutaneous involvement as the initial site of disease. Immunologic studies indicated that the neoplastic cells carried surface immunoglobulin (IgMgamma), thus suggesting a B lymphocyte origin for the lymphatic neoplasia.
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Rosetting and non-rosetting lymphocytes collected from normal individuals were stained for the presence of beta-glucuronidase, periodic-acid Schiff activity, gamma glutamyl transpeptidase, acid phosphatase, and alpha-naphthyl butyrate esterase. Lymphocytes which formed rosettes with sheep erythrocytes and non-rosette forming lymphocytes contained cytochemical reaction products for all five stains. Beta-glucuronidase (P less than 0-02) and acid phosphatase (P less than 0-01) were more frequently found in rosette forming lymphocytes. However, non-rosetting cells were more frequently periodic-acid Schiff positive (P less than 0-001). Gamma-glutamyl transpeptidase and alpha-naphthyl butyrate esterase were present equally in rosette and non-rosette forming lymphocytes. In addition, 33 non-Hodgkin's lymphomas were studied for cell surface markers and cytochemical reactions. In 17 of 19 B cell lymphomas, there was a paucity of lymphocytes containing beta-glucuronidase. However, in three of four T cell proliferations, there were numerous lymphoid cells positive for beta-glucuronidase. The periodic-acid Schiff and acid phosphatase reactions varied greatly within B, T, and null cell lymphomas and thus were of little diagnostic value in determining the cell of origin of these neoplastic lymphoid cells.
Peripheral blood lymphocytes are heterogeneous and can be divided into subpopulations based on cell surface markers. Lymphocytes from 101 normal individuals of all ages were tested for their ability to form spontaneous rosettes with sheep erythrocytes (T cells) and for surface immunoglobulins (B cells). Cord bloods of newborn infants and bloods from children (age 1-10 years) showed greater numbers of total lymphocytes, total T cells and unmarked cells than a control group of 50 individuals from age 11-60 years. In 22 normal elderly individuals (age 61-98 years), total lymphocytes and total T and B cells were not decreased. These data suggest that the depression of cellular immune response described in elderly populations may be related to a dysfunction in a segment of T cells or an aberration in the complex interaction among T cells, B cells and macrophages.
A histiocytic lymphoma with a terminal leukemic phase occurred in a 50-year-old man. Immunologic studies indicated that neoplastic cells from the peripheral blood sample, bone marrow aspirate, and lymph node carried surface immunoglobulin. Cytochemical and immunohistochemical analysis of this histiocytic lymphoma and its subsequent leukemic phase displayed a profile consistent with a lymphocytic rather than a histiocytic origin of the neoplastic cell.
We describe a patient with multiple myeloma characterized by clinically evident extramedullary metastasis and marked anaplastic alterations of neoplastic cells. We describe the technique that detected the presence of intracytoplasmic immunoglobulin IgGk in mature plasma cells from paraffin-fixed tissue obtained from an iliac lesion and in anaplastic tumor cells infiltrating a lymph node from which a biopsy specimen was taken three years later. These data confirm that both tissues were composed of a cell with identical origin. In addition, the immunohistochemical technique is applicable for the identification of other antigens present in paraffin-embedded tissue.
Lymphoblasts from 6 cases of acute lymphocytic leukemia showed a paucity of receptors for T-cells (E-rosettes) and B-cells (surface membrane immunoglobulin). In contrast, neoplastic lymphoid cells from 5 cases of non-Hodgkin's lymphoma demonstrated that 4 cases could be listed as B cell proliferations and 1 case as a T-cell tumor, Anomalous HLA cytotoxic reactions were observed in all 6 cases of acute lymphocytic leukemia and probably in 1 case of non-Hodgkin's lymphoma. When the HLA antisera was absorbed of its HLA specificity, lymphoblast cytotoxicity was still observed, indicating the presence of some contaminating nonHLA antibody in HLA antisera. Severson et al. (3) demonstrated the presence of anti-B-cell activity in 2 of the 4 antisera used in this study. Lymphoblasts failed to stimulate autologous peripheral blood remission lymphocytes and neoplastic lymphoid cells did not stimulate autologous peripheral blood lymphocytes in mixed lymphocyte culture, indicating the lack of a neoantigen as measured by this technique. However lymphoblasts from 4 cases of acute lymphocytic leukemia and neoplastic lymphoid cells from 2 cases of B-cell lymphoma stimulated better than they responded to allogeneic lymphocytes. The data suggest the possibility that lymphoblasts without receptors of E-rosettes and surface membrane immunoglobulin may contain B-cell antigens which crossreact with HLA antisera and vigorously stimulate allogeneic lymphocytes.
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Lymph nodes were obtained from 28 patients with non-Hodgkin's lymphoma and 24 patients without hematologic malignancy. Cases of undifferentiated lymphoma, diffuse histiocytic lymphoma, diffuse and nodular mixed histiocytic-lymphocytic lymphoma, nodular poorly differentiated lymphocytic lymphoma, and diffuse well differentiated lymphocytic lymphoma were analyzed. Touch preparations were stained for nonspecific esterases, peroxidase, Sudan black B activity and with periodic acid-Schiff and Wright-Giemsa reagents. Mononuclear cell suspension from lymph nodes and, in some cases, peripheral blood were tested for spontaneous rosette formation with sheep erythrocytes and for the presence of surface immunoglobulin. The remainder of the lymph node was examined after staining with hematoxylin and eosin. Analysis of the lymphocyte surface markers indicated that 15 cases of various histologic types of lymphoma were B cell proliferations. However, three out of four cases of diffuse poorly differentiated lymphocytic lymphoma and one of seven cases of diffuse histiocytic lymphoma appeared to represent T cell neoplasia. Lymph nodes from four cases of lymphoma representing diverse histologic types were replaced by neoplastic cells devoid of discernible cell markers. In five cases, the distribution of cell surface markers in the malignant lymph node failed to differ from data obtained in the analysis of non-neoplastic lymph nodes. The study indicates that the histopathologic entities recognized in the currently employed classification of lymphoreticular malignancies are heterogeneous. Alterations in the distribution of cell surface markers in the peripheral blood from five of 12 patients indicated involvement prior to demonstrable morphologic evidence of peripheral blood involvement in four patients and bone marrow infiltration in two patients.
Lymph nodes were biopsied from seven patients with the presumptive clinical diagnosis of lymphoma and studied for their ability to form spontaneous rosettes with sheep erythrocytes (T cell marker), for surface immunoglobulins (B cell marker), for cytochemical reactivity with peroxidase, alpha-naphthyl acetate and butyrate esterases, naphthol ASD chloroacetate esterase, acid phosphatase, periodic acid-Schiff, Sudan black B, and Wright-Giemsa on touch preparations, as well as in hematoxylin and eosin-stained sections. Lymph nodes from patients without hematologic malignancy served as control. Diagnoses of diffuse histiocytic lymphoma were made in five cases and diffuse mixed histiocytic-lymphocytic lymphoma in 2 cases. The cytochemical staining of the lymphoma cells were typical of lymphoid cells rather than macrophages. In five cases neoplastic cells contained surface immunoglobulins, suggesting a B cell origin, and in one case a paucity of cell surface markers was found. Cells from uninvolved nodes of lymphoma patients could not be differentiated from those of the control group.
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