Non-Hodgkin's lymphoma: identification of the monoclonal B lymphocyte component in the presence of polyclonal immunoglobulin

A high proportion of non-Hodgkin's lymphomas are neoplastic proliferations of B lymphocytes, and, as such, express integral membrane and/or cytoplasmic immunoglobulin (Ig). Because these cellular proliferations are monoclonal, the Ig of all neoplastic lymphocytes will have identical light chain type and idiotype. These tumors sometimes contain significant amounts of polyclonal Ig. In this study we demonstrate that the polyclonal non-B-lymphocyte-associated Ig may be removed by washing tissue at low pH to reveal either neoplastic B lymphocytes or neoplastic "null" lymphocytes. These observations should facilitate the application of immunohistology to the routine diagnosis of lymphoma.

T-lymphocyte subsets in follicular lymphomas compared with those in non-neoplastic lymph nodes and tonsils

Using monoclonal antibodies on frozen sections, the authors define the anatomic localization of T-lymphocyte subsets in follicular lymphomas as well as in nonneoplastic lymph nodes and tonsils. The percentage of Leu-1+ T cells in the follicles of follicular lymphomas (20 per cent) was virtually identical to that seen in the follicles of nonneoplastic lymph nodes or tonsils (22 per cent). There were 50 per cent T cells in the interfollicular regions of follicular lymphomas and 75 per cent in the paracortical regions of the nonneoplastic specimens. In neoplastic follicles the number of Leu-3a+ cells was 67 per cent of the number of Leu-1+ cells, whereas, virtually the entire T-cell population in the nonneoplastic follicles expressed the Leu-3a antigen. These T cells of helper phenotype may facilitate the neoplastic process or an immune response against it or may be bystanders to the B-cell proliferation. Hum Pathol 13:618-625, 1982

Establishment and characterization of an Epstein-Barr virus-negative lymphoma B-cell from a patient with a diffuse large cell lymphoma

Cell line (LNPL) was established from a tumor biopsy of a nasopharyngeal "histiocytic" lymphoma composed of large noncleaved B-cells. LNPL expressed immunoglobulin M kappa surface immunoglobulin, as did the original tumor. LNPL also expressed Ia antigen but lacked Epstein-Barr virus nuclear antigen. It exhibited a translocation between chromosomes 8 and 14 which has been described in certain other malignant lymphoproliferative disorders. An autologous T-cell line lacked the translocation between chromosomes 8 and 14. LNPL is being used as an immunogen to produce monoclonal antibodies in our laboratory. Such cell lines may facilitate identification of lymphoma-associated surface antigens.

Immunoblastic sarcoma: morphologic criteria and the distinction of B and T cell types

Immunologic concepts have facilitated the recognition within the histiocytic lymphoma group of the Rappaport classification of five diagnostic categories of lymphoma (follicular center cell lymphoma large cleaved and large non-cleaved types, immunoblastic sarcoma B cell type, immunoblastic sarcoma T cell type and 'true histiocytic lymphoma'). The first four of these 'large cell lymphomas' are closely related biologically and are difficult to distinguish histologically. This paper purports to examine the morphologic criteria employed in the differential diagnosis of these four large cell lymphomas in an objective manner, utilizing carefully prepared histologic sections from 24 cases of lymphoma that had been subjected to detailed B and T cell characterization by surface marker methods. 18 morphologic criteria were evaluated by four observers independently. The results show that reliable histologic distinctions can be made on histologic grounds in a proportion of cases only and that individual criteria show more overlap within diagnostic criteria than previously recognized. This is attributed in part to the close biologic relationship of these neoplasms. It is also recognized that the morphologic criteria are subtle and that the pathologist should have the advantage of auxiliary techniques--cytochemistry, immunohistology, surface marker techniques--to achieve reliable distinction of functional types within the diffuse histiocytic group of Rappaport.

Nodular mixed cell lymphoma with monoclonal gammopathy

Malignant lymphomas are rarely accompanied by a serum M component. Such neoplasms are usually of lymphocytic cell type and, with extremely rare exceptions, of diffuse pattern. A patient with an unusual malignant lymphoma of mixed cell type characterized by follicular structures and vascular proliferation was found to have a serum monoclonal gammopathy (IgM kappa) of over 4 g/dl. Remission accompanied by a pronounced reduction in the M protein was achieved with Chlorambucil. Subsequent relapse was characterized by the emergence of a large cell lymphoma with IgM kappa surface immunoglobulin. No concomitant rise in the serum M component accompanied relapse.

Studies on blood lymphocytes of patients with nodular poorly differentiated lymphocytic lymphoma

T and B lymphocytes were measured in pretreatment blood samples from patients wih nodular poorly differentiated lymphocytic lymphoma (NPDLL). There were significant differences in T cell values between control groups and patients with NPDLL. In 13 out of 20 cases of NPDLL blood lymphocytes showed abnormalities of immunoglobulin light chain expression and were considered to show an abnormal clonal expansion of B lymphocytes. The abnormal clone of B cells in the blood reflected that found in lymph nodes and could be detected in the absence of bone marrow involvement or blood lymphocytosis.

Follicular center cell lymphoma of childhood: a report of three cases and a discussion of its relationship to Burkitt's lymphoma

Three children with follicular center cell lymphomas are reported. The tumors were studied by light microscopy, electron microscopy, and the immunoperoxidase technique. All three tumors contained monotypic immunoglobulin; one had the morphology of a 'signet ring cell lymphoma,' and one had arisen in a child with Bloom's syndrome. Two tumors exhibited a nodular or partly nodular growth pattern. The tumors were compared with African cases of Burkitt's lymphoma and found to have marked differences in their morphologic and immunohistochemical characteristics. The authors believe that one should distinguish between Burkitt's lymphoma and follicular center cell lymphomas occurring in childhood.

[The distribution of B-lymphocytes in lymphoepithelial tissues as well as in tumors of the neck-, nose-, and throat region derived from lymphoreticular and lymphoepithelial tissues (author's transl)]

B-Lymphocytes carrying IgG-, IgM,- and IgA-surface receptors were estimated by fluorescence microscopy in the palatine tonsil of 50 patients aged 3 to 18 years as well as in 44 patients with various types of malignant lymphoms and lymphoepithelial carcinomas. Hyperplastic tonsillartissue contains large numbers of B-cells with a marked variability in concentration (4-30% IgG-cells, medium 12,9%;6-36 IgM-cells, medium 23.4%;3-38% IgA cells, medium 20.8%). There appears to exist an age-dependent increase in IgM-cells and an increase in IgG-and IgA-cells in patients with numerous recurrent infections of the upper respiratory tract. Malignant lymphomas can be grouped into three main categories: Such with a predominance of one B-cell line (above 75-80% of one immunological cell type); these include primarily malignant lymphomas of the well differentiated lymphocytic type (IgM and IgA receptors). Secondly, such with a significant decrease in B-cells (below 10%) which include primarily malignant lymphomas of the poorly differentiated lymphocytic type. Thirdly, such with an increased B-cell content but with more than one cell line participating in cell proliferation. The latter ones comprise certain cases of Hodkin's lymphomas. Lymphoepithial carcinomas are charactersized by a significant decrease in total B-cell content, except for IgE- and IgD-cells which were not investigated. The results show that the immunologic classification of malignant lymphomas correlates only to a certain degree with the morphologic classification; i.e. the same morphologic type of tumor may possess different immunologic characteristics. Since the immunologic characteristics may reflect a certain functional potential of these tumors as well as probably a certain kind of immunologic incompetence prior to tumor development, it is suggested, that future morphologic investigations of malignant lymphomas and lymphoepithelial carcinomas are combined with immunologic classifications.

[Quantitative behavior of immunoglobulins in Hodgkin patients following splenectomy]

The values of immunoglobulins in 14 patients with malignant lymphoma were determined before and 1 to 44 weeks following splenectomy. The IgM-fraction showed a significant decrease in all cases, whereas the IgG- and IgA-fraction showed no change in its concentrations. The reason for the IgM-decrease is probably due to the absence of IgM-producing cells in the spleen.