Immunohistologic detection of immunoglobulins in malignant lymphomas and its value in histopathologic diagnosis

Immunoelectronmicroscopic profile of intracytoplasmic immunoglobulins in B non Hodgkin's malignant lymphomas. Comparison with the normal pattern of B lymphoid cells

An immunoelectronmicroscopic method using Fab fragment of anti human IgG (H + L) has been employed to study the localization of cytoplasmic immunoglobulins in the tumoral cells of 12 B non Hodgkin's malignant lymphomas (B-M.L.). A comparison with normal homologous B lymphoid cells was performed on 10 non tumoral reactive lymph nodes. Immunostaining was observed in PNC, RER and Golgi complex. The criterions of differentiation were discussed in the different B-M.L.. Because of a granular hyaloplasmic immunostaining in normal and tumoral centroblasts and immunoblasts, monospecific antibodies against gamma, mu, alpha heavy chains were used to rule out a non specific uptake. Presence of mu heavy chain was discussed as an argument for immunoglobulin free ribosomal synthesis.

Immunoenzymatic typing of lymphoplasmacytoid skin infiltrates

Monoclonal immunoglobulin-producing lymphomas (immunocytomas, plasmacytomas, and immunoblastomas) constitute 15 to 20% of all cutaneous lymphomas. Their differentiation from polymorphous lymphoplasmacytoid inflammatory or pseudolymphomatous infiltrates may be difficult if sections are stained for a single light chain only. It was the aim of the study to elucidate the ratio of the kappa- to lambda-positive cells in 10 lymphoproliferative, 5 pseudolymphomatous, and 42 inflammatory lymphoplasmacytoid cutaneous infiltrates and to characterize them by the type of Ig (alpha, gamma, mu, kappa, or lambda) synthesized intracellularly. An indirect immunoenzymatic double-labeling method (alkaline phosphatase and peroxidase) was used for the simultaneous demonstration of kappa and lambda light chains and alpha, gamma, and mu heavy chains in paraffin sections. Ig-producing lymphomas of the skin show patchy monoclonal proliferations of cells synthesizing kappa IgM in almost 50% of the cases (5 of 10). Monoclonality is claimed if the ratio of lambda- to kappa-positive cells is at least 1:10, or vice versa. In polyclonal inflammatory and pseudolymphomatous infiltrates, the lambda/kappa ratio never exceeds 1:5. The most common cell type found in these reactive infiltrates produces gamma heavy chain; some produce alpha chain, but only a few produce mu chain. In high-grade malignant lymphomas, the tumor cells may lose their capacity for Ig production.

[Chronic lymphatic leukemia of B-cell type: clinical and morphological investigations for diagnostic differentiation (author's transl)]

Chronic lymphatic leukemia (CLL was diagnosed in 71 patients based on clinical data. Most of the patients were in the stages 0, I and II, only 18% were in the stages III and IV according to Rai. In all cases, the disease was characterized by an increased number of B lymphocytes (B-CLL). The B cells mostly expressed a weak fluorescence intensity when tested for membrane bound immunoglobulins (Ig). In accordance to that, the quantitative measurement of Ig in the serum revealed a decrease of one or more Ig classes in 72% of the patients. No correlation existed between the number of b lymphocytes (and T lymphocytes) or the Ig concentration in the serum and the stage of the disease. To distinguish the CLL from related lymphoproliferative disorders, especially the immunocytic lymphoma, lymph node biopsies were examined histologically and immunomorphologically for intracytoplasmic Ig. This examination confirmed the diagnosis of CLL in 33 out of 40 cases. Six lymph nodes were classified as immunocytic lymphoma of the lymphoplasmacytoid type. In three of the latter, the immunocytic lymphoma was clinically associated with decreased Ig concentrations in the serum. These findings emphasize that the clinically established diagnosis of CLL should be corroborated by immunomorphology.

Immunohistological studies on primary reticulosis of the canine brain

Brains of 17 dogs with primary reticulosis, and of two with metastatic and one with primary lymphosarcoma, were examined by immunohistologic techniques with antisera against the major immunoglobulin classes of the dog. On the basis of immunoglobulin in tumour cells, two reticuloses were reclassified as primary lymphosarcomas of the brain. The tumour cells in three other dogs with neoplastic reticulosis and in six dogs with microgliomatosis did not contained immunoglobulin. Many cells in inflammatory reticulosis were immunoglobulin-bearing. Although some of these lesions could have been lymphosarcomas, insufficient data were available to ascertain either an inflammatory or a neoplastic nature. It was concluded that some lesions previously classified as reticulosis are in fact primary histiocytic lymphosarcomas of the brain, while others may be true reticulosarcomas.

Lymphomas and pseudolymphomas of the alimentary tract. An immunohistochemical study with clinicopathologic correlations

One hundred one lymphoproliferative lesions of the gastrointestinal tract (66 malignant lymphomas, 20 pseudolymphomas, and 5 borderline lesions) were reviewed. The pathologic features were compared to the clinical findings, with reference to differential diagnosis and prognosis. Special attention was paid to immunohistochemical features. The gross appearance was diagnostic in only a limited number of cases. Endoscopic biopsy alone was also of limited value because only a diagnosis of probability could be made in several cases. In most of them the definitive diagnosis had to be based on histologic examination of the resected specimen. Immunohistochemical examination was found to be very useful as an ancillary diagnostic technique. Malignant lymphomas displayed either cytoplasmic immunoglobulins with a monoclonal pattern (47.1 per cent) or a negative reaction, whereas the pseudolymphomas were generally characterized by polyclonal immunoglobulins. Ninety per cent of malignant lymphomas with cytoplasmic immunoglobulins contained lambda chains. The survival probability was found to be related to the size of the lesion, the depth of infiltration, and the immunohistochemical characteristics of the tumors. The histologic type of the lymphomas was of limited value as a predictor of prognosis in the present series.

Plasma cell counts on human jejunal biopsy specimens examined by immunofluorescence and immunoperoxidase techniques: a comparative study

Ten human jejunal biopsy specimens were examined by both immunofluorescence (IF) and immunoperoxidase (IP) methods to compare both plasma cell counts and the distribution of extracellular immunoglobulins. Each specimen was cut into at least two portions, one fixed in 5% formaldehyde in phosphate-buffered saline before being snap-frozen and sectioned on a cryostat for IF, the other being fixed in half-strength Zenker and embedded in paraffin wax by standard methods for IP. Plasma cell counts were comparable in the eight biopsy specimens for which they could be estimated, geometric mean values being IgA 22.9 (IF), 19.3 (IP) and IgM 9.5 (IF), 10.6 (IP). Two specimens showing subtotal villous atrophy had too much extracellular IgA for plasma cell counts to be feasible. For these the IF methods had the advantage that the extracellular immunoglobulin was more readily distinguishable from background staining.

Primary cerebral malignant lymphoma with macroglobulinemia and carcinoma of the colon

A case of primary cerebral malignant lymphoma, immunoblastic type was reported. The immunoelectrophoresis of the patient serum showed an abnormal bow of IgM lambda type. Autopsy revealed that the cerebral lymphoma showed no extracranial spread except for adenocarcinoma of the colon with hepatic metastasis. Ultrastracturally, some of the lymphoma cells showed plasmacytoid differentiation. Immunoperoxidase study showed intracytoplasmic polyclonal immunoglobulins in non-neoplastic plasma cells around the colonic carcinoma, in the bone marrows, and spleen. However, neither IgM nor lambda light chain was found in the cerebral lymphoma cells. The source of the macroglobulinemia in this case was discussed.

Primary intracranial malignant lymphomas a fine structural cytochemical and CSF immunological study

Cytochemical and electron microscopical studies in six cases of primary intracranial malignant lymphomas, four of which were diagnosed by biopsy, confirmed their ultrastructural identity with extraneural malignant lymphomas classified as immunoblastomas and immunocytomas. Demonstration of transformation of 'blast-like' cells (immunoblasts) toward rough E. R. developing cells in all these tumours argue for the B-dell origin of these types of cerebral lymphomas, previously referred to as reticulum cell sarcomas/microgliomas. CSF studies showed increased levels of B cells with surface IgG in two cases of immunoblastoma, and increased IgG levels with light chains in two cases each immunoblastoma and of pleomorphic immunocytoma, while one case of immunoblastoma showed a normal T cell to B cell ratio with increased monoclonal and surface, IgM suggesting some morphological and immunological heterogeneity of these lymphomas.