Malignant rabbit fibroma virus causes secondary immunosuppression in rabbits

Shope fibroma virus (SFV) causes a localized, self-limited, fibroblastic proliferation in adult rabbits. Extracts of Shope fibroma tumors were found to contain a second virus that induces a rapidly progressive disseminated tumor. Dissemination of this malignant fibroma is associated with activation of commensal mucosal infection with Pasteurella multocida, causing purulent conjunctivitis and rhinitis and resulting in death from nasal obstruction. We have isolated this new agent by two cycles of plaque purification. It is a poxvirus that is antigenically virtually identical to SFV as measured by a plaque reduction assay, but behaves differently both in vivo and in vitro. We have called this virus malignant rabbit fibroma virus (MV). Electrophoresis of restriction digests made with HIND III indicates that despite the antigenic similarity of SFV and MV, the locations of HIND III sites in the two viral genomes are quite different. These experiments have enabled us to determine that MV was present in small quantities in our initial uncloned stock of Patuxent strain SFV. Lymphocytes from rabbits bearing MV-induced tumors responded poorly to both B and T lymphocyte mitogens. This nonspecific immunologic dysfunction is evident at or before the time when metastases and Gram-negative infection develop, and it becomes more profound as the disease progresses. MV-induced tumors may provide a model for Gram-negative infection and decreased immunologic responsiveness associated with malignancies.

Cutaneous Hodgkin's disease

Involvement of the skin in advanced Hodgkin's disease is well known. However, Hodgkin's disease initially seen in the skin is extremely rare. A patient had Hodgkin's disease that was initially seen as a cutaneous lesion on the buttock. Lymphadenopathy developed two months after completion of local radiotherapy to the cutaneous lesion and seven months after initial diagnosis. The histologic changes in both instances were those of Hodgkin's disease. We discuss problems in the diagnosis and treatment of skin involvement with Hodgkin's disease.

Proliferative responses of rabbit lymphocytes to Pasteurella multocida decrease with prolonged immunization

Peripheral blood and splenic lymphocytes from rabbits immunized with Pasteurella multocida by various schedules were stimulated to undergo blast transformation in vitro in response to this antigen. Repeated immunizations suppressed this response.

Acute myelomonocytic leukemia presenting as a primary cutaneous lymphoma of true histiocytes

Malignant histiocytic and monocytic infiltrates of the skin are seen in true histiocytic lymphomas, in malignant histiocytosis, and in monocytic leukemias. Occasionally such cutaneous lesions constitute the presenting manifestation of the underlying malignancy. We report here a patient whose first manifestation of acute myelomonocytic leukemia was a malignant histiocytic infiltrate in the skin. Cytochemical and electron microscopic data confirmed the histiocytic nature of the skin tumor, and cytochemical data documented the myelomonocytic nature of the subsequent leukemia. Purely histiocytic skin tumors do not often presage myelomonocytic leukemias, although they have developed into monocytic leukemias, and monocytic leukemias have been transformed into myelomonocytic leukemias.

The histologic spectrum of the cutaneous mycobacterioses

The authors examined the histopathology of cutaneous involvement in 31 cases of nonleprous mycobacterial infection. Cases include three patients with Mycobacterium kansasii infection, two with M. fortuitum infections, and one each with M. marinum and M. chelonei infections, as well as 18 with M. tuberculosis infections. In the remainder, species were not identified. The histopathologic picture was variable and often did not suggest mycobacterosis. The authors identified seven basic pathologic patterns of skin involvement: 1) abscess, 2) well-formed (tuberculoid) granulomas, 3) diffuse histiocytic infiltration, 4) panniculitis, 5) nonspecific chronic inflammation, 6) naked (sarcoidal) granulomas, and 7) rheumatoid-like nodules. Intermediate forms were also found. Some cases showed adnexal or epidermal involvement, while others showed variably distributed dermal infiltration. The results indicate that a wide variety of cutaneous, clinical, and histologic guises may be assumed by mycobacterial infections in normal and immunocompromised hosts.

Insulin-specific antibodies and insulitis in mice immunized with purified porcine insulin

The murine antibody response to porcine insulin is controlled by immune response genes of the major histocompatibility complex. Animals of the one haplotype (H-2d) produce specific antibodies to pork insulin, while animals of other haplotypes do not. We analysed the antibody responses to purified pork insulin by animals of responder and non-responder haplotypes, and attempted to correlate these responses with histopathological findings at necropsy. Animals of responder and non-responder haplotypes immunized with insulin or control preparations generally presented similar pathological pictures. We found granulomatous inflammatory infiltrates in the liver and the periphery of the pancreas, mononuclear interstitial pancreatic infiltrates, and mononuclear hepatic pericholangitis. Those were ascribe to adjuvant. One animal (H-2d) immunized with insulin showed focal peri-insulitis. Otherwise, the inflammatory infiltrates in the islets reported by others were not observed. The significance of insulitis in experimental insulin immunity is discussed.

Gastric cytomegalovirus infection in bone marrow transplant patients: an indication of generalized disease

Cytomegalovirus infection in immunosuppressed patients is well known. It usually appears as an interstitial pneumonitis that may progress to a disseminated viral infection. The authors report on two patients who, after bone marrow transplantation, had signs and symptoms of gastric ulceration as the initial manifestation of cytomegalovirus infection. Both died with disseminated cytomegalovirus infection. Though gastric presentation is unusual for cytomegalovirus infection, epigastric pain and gastrointestinal hemorrhage in a bone marrow transplant patient may herald a potentially lethal viral infection.

Adnexal metaplasia in carcinoma in situ of the skin

Two cases of epidermoid carcinoma in situ of the skin, one with mucinous metaplasia and the other with sebaceous metaplasia, are reported. These unique cases suggest a spectrum of differentiation possible by neoplastic epidermal keratinocytes, which may help in the understanding of the histogenesis of certain skin neoplasms.

Histoplasmosis presenting as the carpal tunnel syndrome

An otherwise asymptomatic 53 year old woman presented with symptoms typical of median nerve compression in the carpal tunnel. At operation, the tendon sheath was obviously inflamed. The diagnosis of histoplasmosis was made on microscopic examination of the surgical specimen. Cultures of synovial tissue grew H. capsulatum. Review of the literature and of experience at Barnes Hospital indicates that the carpal tunnel syndrome is a very unusual primary manifestation of histoplasmosis. However, as histoplasmosis is a treatable cause of the carpal tunnel syndrome, this diagnosis should be considered in endemic areas.

Primary lymphoma of the liver

We report here the case of a man who presented with nonspecific clinical symptoms and was found to have abnormal liver function tests and large filling defects on liver scan. At autopsy, a primary histiocytic lymphoma of the liver was found. The liver is frequently involved secondarily by lymphoma; primary hepatic lymphoma however however is rare, only five cases haveing been previously reported.

Congenital glomerulosclerosis and nephrotic syndrome in two infants. Speculations and pathogenesis

The incidental finding of hyalinized glomeruli in otherwise normal infant kidneys is referred to as congenital glomerulosclerosis. Two infants had extensive glomerulosclerosis manifested by nephrotic syndrome, severe oliguria, and progressive renal failure. Both patients were believed to have had intrauterine infections. These two cases have unequivocally identified congenital glomerulosclerosis as one of the causes of nephrotic syndrome in infancy. In addition, they suggest that extensive glomerulosclerosis in some cases may be a result of congenital infections.

Dysplasia of the kidneys, liver, and pancreas: report of a variant of Ivemark's syndrome

A newborn girl with respiratory distress due to bilateral pneumothorax was found to be anuric, and died at 18 hours of age. Autopsy revealed a large pancreatic cyst, multiple large hepatic cysts, congenital hepatic fibrosis, bilateral dysplastic kidneys, and dysplasia of the pancreas. These findings constitute a variant of Ivemark's syndrome of dysplasia of the pancreas, liver, and kidneys.

H-2 linked Ir gene control of antibody responses to porcine insulin. I. Development of insulin-specific antibodies in some but not all nonresponder strains injected with proinsulin

Cell-mediated and humoral immune responses to heterologous insulins in mice are controlled by H-2 linked, dominant, immune response (Ir) genes. For example, mice bearing the H-2d haplotype develop T cell proliferative responses and produce antibody after injection with porcine insulin, whereas mice bearing other H-2 haplotypes do not. Data presented in this communication demonstrate that homozygous and heterozygous H-2d mice produce insulin-binding antibodies when immunized with porcine insulin or proinsulin. Some (H-2b,k,s) insulin-nonresponder mice produce insulin-binding antibodies after injection of proinsulin, whereas other insulin-nonresponder strains (H-2q) do not. All strains, except homozygous H-2q mice, produce antibodies specific for proinsulin, suggesting that the response to porcine proinsulin is also controlled by H-2-linked Ir genes. More importantly, F1 hybrids between insulin-nonresponder C57BL/10 (H-2b) and DBA/1 (H-2q) produce no insulin-binding antibodies when injected with proinsulin, despite the fact that proinsulin-binding antibodies are produced by these mice.

Anti-receptor antibody. II. Induction of long-term unresponsiveness in neonatal mice

We have examined the ability of anti-receptor antibody (ARA) to induce specific unresponsiveness to the hapten, phosphorylcholine (PC), in neonatal and adult mice. When ARA is given to adult mice, suppression is of short duration. Cells from such mice are responsive in vitro, indicating that suppression in vivo is probably due to blockade of receptors by persisting ARA. ARA given to neonatal mice induces long-term unresponsiveness. The mice apparently have decreased numbers of PC-responsive cells, since cells from such mice are unresponsive both in vitro and in adoptive transfer. Furthermore, cells from neonatally suppressed animals do not suppress the response of normal cells either in vitro or in adoptive transfer, indicating that unresponsiveness is most likely not due to active suppression. We therefore conclude that ARA given to neonates depletes the clone of receptor-bearing cells at the time ARA is given. Clonal depletion may result from antibody-dependent cell mediated cytotoxicity.

Anti-receptor antibody. I. Isolation and characterization of the immunoglobulin receptor for phosphorylcholine

We have demonstrated a phosphorylcholine-binding protein in lysates from radioiodinated splenocytes of immunized mice. Immunoprecipitation with anti-receptor antibody of lysates from splenocytes obtained from animals undergoing a primary response or from mice immunized 4 to 6 months earlier with antigen demonstrated that this protein contained H and L chains. Therefore, we have isolated an antigen-specific receptor from the surface of spleen cells from both immunized and "memory" animals. This receptor Ig comprises approximately 10% of total cell surface Ig.

Clonal depletion in neonatal tolerance

Specific unresponsiveness can be induced in neonatal and adult BALB/c mice by antibody against antigen-specific receptor (antireceptor antibody). When heterologous antireceptor antibody is used in the indirect fluorescence technique, the number of fluorescent cells in these animals is significantly lower than in normal animals. Fluorescent cells appear after a relatively brief incubation of cells from adult-suppressed animals, whereas no fluorescent cells are detected when cells from neonatally treated animals are incubated briefly. Evidently, treating neonatal mice with antireceptor antibody specifically depletes the antigen-responsive clone. In contrast, antireceptor antibody causes reversible blockade of responsive cells in adult-suppressed animals.

Neonatal tolerance induced by antibody against antigen-specific receptor

Specific immunologic unresponsiveness is induced by injecting adult or neonatal mice with antibody against antigen-specific receptor (antireceptor antibody). Suppression in mice treated as adults lasts several weeks, and cells from these suppressed mice respond normally in culture. In contrast, unresponsiveness induced in neonatal mice is long-lasting; cells from these mice do not respond in culture and do not affect the response of normal cells. Evidently, antireceptor antibody reversibly blocks antigen receptors in adult animals, but induces unresponsiveness in neonatal mice by depleting the clone of receptor-bearing cells.