Production and characterization of monoclonal antibodies specific for types 6 and 19 pneumococcal capsular polysaccharides

The primary IgM and the secondary IgG antibody responses to pneumococcal capsular polysaccharides type 19 (S19) and type 6 (S6) coupled to sheep erythrocytes (S19-SRBC or S6-SRBC) differ in specificity. Although the primary IgM response appears to be totally specific for the pneumococcal cell wall carbohydrate (PnC) which is present in these polysaccharide preparations, the secondary IgG response appears to be completely specific for the immunizing capsular polysaccharide. A library of B cell hybridomas from fusions of splenocytes undergoing a primary response to an S19 preparation consisted entirely of PnC-specific hybrids. Thus, no evidence was obtained for the presence of capsular polysaccharide-specific IgM secreting B cells. IgM and IgG antibody secreting hybridomas were obtained, from fusions of splenocytes undergoing secondary S6- or S19-SRBC responses, to examine the antigen specificity of secondary antibody response of B cells at the clonal level. Many of the secondary IgM hybridomas secreted PnC-specific antibody; however, several S6-specific IgM secreting hybrids were also obtained, demonstrating a previously undetected population of B cells. All IgG secreting hybridomas obtained from S19- or S6-SRBC secondary response fusions secreted capsular polysaccharide-specific antibody, thus confirming the apparent absence of PnC-specific IgG secreting B cells in these responses. This method of immunization and challenge of mice with capsular polysaccharide coupled to erythrocytes, which results in the production of capsular polysaccharide-specific IgG responses, offers a relatively straightforward means to generate monoclonal antibodies specific for pneumococcal capsular polysaccharides.     

Distinction between hepatocellular carcinoma, cholangiocarcinoma, and metastatic carcinoma based on immunohistochemical staining for carcinoembryonic antigen and for cytokeratin 19 on paraffin sections

An antiserum to carcinoembryonic antigen (CEA) and a monoclonal antibody to cytokeratin 19 (CK 19) were studied for their suitability as diagnostic reagents for the differential diagnosis of primary and secondary malignant epithelial tumours of the liver, on paraffin sections. With the antiserum to CEA, positive bile canalicular structures were found in 60 per cent of the hepatocellular carcinomas. All the cholangiocarcinomas and 66.6 per cent of the metastatic carcinomas were positive for CEA, without displaying a canalicular staining pattern. All the hepatocellular carcinomas were negative for CK 19. All the cholangiocellular carcinomas and the metastatic carcinomas were positive for CK 19. This staining profile may prove helpful in difficult diagnostic cases.     

Type 6 and 19 pneumococcal polysaccharides coupled to erythrocytes elicit pneumococcal cell wall-specific primary IgM responses and capsular polysaccharide-specific secondary IgG responses

Previous results have shown that the primary murine antibody responses to vaccine preparations of type 6 (S6; Danish type 6A) or type 19 (S19; Danish type 19F) pneumococcal capsular polysaccharides consist entirely of IgM antipneumococcal cell wall carbohydrate (PnC)-specific antibodies. No capsular polysaccharide-specific IgM antibodies were detectable by plaque-forming cell or enzyme-linked immunosorbent assay techniques. In this report, antibodies specific for S6 and S19 capsular polysaccharides were induced in secondary responses to chicken erythrocyte (CRBC) conjugates of S6 and S19. Essentially all detectable IgG produced in the secondary response was capsular polysaccharide specific and included all subclasses of IgG. In contrast, all detectable IgM produced in the primary response to S6-CRBC and S19-CRBC, and the IgM produced in the secondary response to S6-CRBC was not capsular polysaccharide specific since it reacted with PnC. Thus, there is a major change in the specificity of the primary IgM response compared to the secondary IgG response of mice immunized with S6-CRBC or S19-CRBC. Injection of PnC or any PnC-containing polysaccharide prior to immunization with S6-CRBC or S19-CRBC resulted in suppression of the primary IgM response. In contrast, only the capsular polysaccharide used in the immunizing polysaccharide-erythrocyte conjugate suppressed induction of the capsular polysaccharide-specific secondary IgG response. These results suggest that S6 and S19 capsular polysaccharide-specific IgG-producing memory B cells derive from capsular polysaccharide-specific precursors which do not produce detectable antibody after primary immunization.     

IL-6, IL-10, sFas,granulysin and indicators of intestinal permeability as early biomarkers for a fatal outcome in COVID-19

The clinical presentation of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ranges between mild respiratory symptoms and a severe disease that shares many of the features of sepsis. Sepsis is a deregulated response to infection that causes life-threatening organ failure. During sepsis, the intestinal epithelial cells are affected, causing an increase in intestinal permeability and allowing microbial translocation from the intestine to the circulation, which exacerbates the inflammatory response. Here we studied patients with moderate, severe and critical COVID-19 by measuring a panel of molecules representative of the innate and adaptive immune responses to SARS-CoV-2, which also reflect the presence of systemic inflammation and the state of the intestinal barrier. We found that non-surviving COVID-19 patients had higher levels of low-affinity anti-RBD IgA antibodies than surviving patients, which may be a response to increased microbial translocation. We identified sFas and granulysin, in addition to IL-6 and IL-10, as possible early biomarkers with high sensitivity (>73 %) and specificity (>51 %) to discriminate between surviving and non-surviving COVID-19 patients. Finally, we found that the microbial metabolite d-lactate and the tight junction regulator zonulin were increased in the serum of patients with severe COVID-19 and in COVID-19 patients with secondary infections, suggesting that increased intestinal permeability may be a source of secondary infections in these patients. COVID-19 patients with secondary infections had higher disease severity and mortality than patients without these infections, indicating that intestinal permeability markers could provide complementary information to the serum cytokines for the early identification of COVID-19 patients with a high risk of a fatal outcome.     

Mechanisms of COVID-19-induced kidney injury and current pharmacotherapies

The COVID-19 pandemic created a worldwide debilitating health crisis with the entire humanity suffering from the deleterious effects associated with the high infectivity and mortality rates. While significant evidence is currently available online and targets various aspects of the disease, both inflammatory and noninflammatory kidney manifestations secondary to COVID-19 infection are still largely underrepresented. In this review, we summarized current knowledge about COVID-19-related kidney manifestations, their pathologic mechanisms as well as various pharmacotherapies used to treat patients with COVID-19. We also shed light on the effect of these medications on kidney functions that can further enhance renal damage secondary to the illness.

     

Response of rat blood, spleen, and lymph node leucocytes to soluble and insoluble antigen

Solubilized sheep erythrocyte stroma was found to be antigenic in rats. Spleen and lymph nodes of rats injected with this antigen contained more 7S than 19S plaque-forming cells throughout the primary and secondary responses. When compared to the primary response, secondary immunization with this antigen elicited increased numbers of both 19S and 7S plaque-forming cells. Antibody synthesizing leucocytes in the blood during the primary and secondary responses were predominantly 7S producers during the first few days. Later 19S producers predominated.

Intact sheep erythrocytes elicited the same pattern of 19S and 7S antibody-forming cell development in the lymph nodes and blood of intravenously injected rats, but during the early primary response in the spleen there was a predominance of 19S over 7S plaque-forming cells. The 7S cells were in a majority during the entire secondary response of the spleen to intact erythrocytes. The secondary response of spleen and lymph node to intact erythrocytes showed an elevated 7S plaque forming cell response but the number of 19S cells was similar to that detecred after primary immunization.

The appearance of haemolytic and haemagglutinating 19S and 7S antibody to sheep erythrocytes or solubilized stroma generally reflected the cellular picture of the spleen. By using an anti-7S globulin it was found that 19S and 7S antibody appeared simultaneously in the serum.

After immunization of rats with intact erythrocytes or solubilized stroma the number of lymphoid cells that took up tritiated thymidine was about one hundred-fold greater than the number of antibody-forming cells as determined by localized haemolysis in gel. The number of lymphoid cells positive in an immunocyto-adherence assay was more closely related to the number of cells taking up tritiated thymidine.

The passive transfer of spleen cells from rats immunized to sheep erythrocytes showed the number of circulating antibody-forming cells in the normal and irradiated recipients to be related to the concentration of antibody-forming cells localizing in the recipient spleen. The number of antibody-forming cells in the peripheral blood was greater in splenectomized recipients. Irradiation had no effect on the number of antibody-forming leucocytes in the circulation of the splenectomized recipients.

     

AFP联合CA19—9检查对良恶性肝病鉴别诊断的临床研究

目的探讨AFP（甲胎蛋白）联合CA19—9（糖链抗原）检查对原发性肝癌、转移性肝癌、肝硬化、病毒性肝炎的鉴别诊断价值。方法采用全自动电化学发光系统对300例各类肝病患者及50例健康对照者进行血清AFP和CA19—9检查。结果原发性肝癌患者AFP值（838．5±175．4）μg／L较其他患者明显增高,而肝硬化患者AFP中度升高,病毒性肝炎和转移性肝癌患者AFP仅轻度升高。当以AFP〉500μg／L作为原发性肝癌诊断界值时,其灵敏度为70.3％．特异性为98．8％。转移性肝癌患者CA19—9值（1265．8±113．4）U／ml较原发性肝癌、肝硬化、病毒性肝炎患者明显增高。结论AFP联合CA19—9检测在原发性肝癌和转移性肝癌,以及对其他良恶性肝病的鉴别诊断具有良好的价值。     

Predictors and microbiology of respiratory and bloodstream bacterial infection in patients with COVID-19: living rapid review update and meta-regression

BackgroundThe prevalence of bacterial infection in patients with COVID-19 is low, however, empiric antibiotic use is high. Risk stratification may be needed to minimize unnecessary empiric antibiotic use.ObjectiveTo identify risk factors and microbiology associated with respiratory and bloodstream bacterial infection in patients with COVID-19.Data sourcesWe searched MEDLINE, OVID Epub and EMBASE for published literature up to 5 February 2021.Study eligibility criteriaStudies including at least 50 patients with COVID-19 in any healthcare setting.MethodsWe used a validated ten-item risk of bias tool for disease prevalence. The main outcome of interest was the proportion of COVID-19 patients with bloodstream and/or respiratory bacterial co-infection and secondary infection. We performed meta-regression to identify study population factors associated with bacterial infection including healthcare setting, age, comorbidities and COVID-19 medication.ResultsOut of 33 345 studies screened, 171 were included in the final analysis. Bacterial infection data were available from 171 262 patients. The prevalence of co-infection was 5.1% (95% CI 3.6–7.1%) and secondary infection was 13.1% (95% CI 9.8–17.2%). There was a higher odds of bacterial infection in studies with a higher proportion of patients in the intensive care unit (ICU) (adjusted OR 18.8, 95% CI 6.5–54.8). Female sex was associated with a lower odds of secondary infection (adjusted OR 0.73, 95% CI 0.55–0.97) but not co-infection (adjusted OR 1.05, 95% CI 0.80–1.37). The most common organisms isolated included Staphylococcus aureus, coagulase-negative staphylococci and Klebsiella species.ConclusionsWhile the odds of respiratory and bloodstream bacterial infection are low in patients with COVID-19, meta-regression revealed potential risk factors for infection, including ICU setting and mechanical ventilation. The risk for secondary infection is substantially greater than the risk for co-infection in patients with COVID-19. Understanding predictors of co-infection and secondary infection may help to support improved antibiotic stewardship in patients with COVID-19.     

Recommendations and guidelines for the diagnosis and management of Coronavirus Disease-19 (COVID-19) associated bacterial and fungal infections in Taiwan

Coronavirus disease-19 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2 that has rapidly evolved into a pandemic to cause over 600 million infections and more than 6.6 million deaths up to Nov 25, 2022. COVID-19 carries a high mortality rate in severe cases. Co-infections and secondary infections with other micro-organisms, such as bacterial and fungus, further increases the mortality and complicates the diagnosis and management of COVID-19. The current guideline provides guidance to physicians for the management and treatment of patients with COVID-19 associated bacterial and fungal infections, including COVID-19 associated bacterial infections (CABI), pulmonary aspergillosis (CAPA), candidiasis (CAC) and mucormycosis (CAM). Recommendations were drafted by the 7th Guidelines Recommendations for Evidence-based Antimicrobial agents use Taiwan (GREAT) working group after review of the current evidence, using the grading of recommendations assessment, development, and evaluation (GRADE) methodology. A nationwide expert panel reviewed the recommendations in March 2022, and the guideline was endorsed by the Infectious Diseases Society of Taiwan (IDST). This guideline includes the epidemiology, diagnostic methods and treatment recommendations for COVID-19 associated infections. The aim of this guideline is to provide guidance to physicians who are involved in the medical care for patients with COVID-19 during the ongoing COVID-19 pandemic.     

National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: lessons from the first wave

ObjectivesThe impact of bacterial/fungal infections on the morbidity and mortality of persons with coronavirus disease 2019 (COVID-19) remains unclear. We have investigated the incidence and impact of key bacterial/fungal infections in persons with COVID-19 in England.MethodsWe extracted laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (1st January 2020 to 2nd June 2020) and blood and lower-respiratory specimens positive for 24 genera/species of clinical relevance (1st January 2020 to 30th June 2020) from Public Health England's national laboratory surveillance system. We defined coinfection and secondary infection as a culture-positive key organism isolated within 1 day or 2–27 days, respectively, of the SARS-CoV-2-positive date. We described the incidence and timing of bacterial/fungal infections and compared characteristics of COVID-19 patients with and without bacterial/fungal infection.Results1% of persons with COVID-19 (2279/223413) in England had coinfection/secondary infection, of which >65% were bloodstream infections. The most common causative organisms were Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Cases with coinfection/secondary infections were older than those without (median 70 years (IQR 58–81) versus 55 years (IQR 38–77)), and a higher percentage of cases with secondary infection were of Black or Asian ethnicity than cases without (6.7% versus 4.1%, and 9.9% versus 8.2%, respectively, p < 0.001). Age-sex-adjusted case fatality rates were higher in COVID-19 cases with a coinfection (23.0% (95%CI 18.8–27.6%)) or secondary infection (26.5% (95%CI 14.5–39.4%)) than in those without (7.6% (95%CI 7.5–7.7%)) (p < 0.005).ConclusionsCoinfection/secondary bacterial/fungal infections were rare in non-hospitalized and hospitalized persons with COVID-19, varied by ethnicity and age, and were associated with higher mortality. However, the inclusion of non-hospitalized persons with asymptomatic/mild COVID-19 likely underestimated the rate of secondary bacterial/fungal infections. This should inform diagnostic testing and antibiotic prescribing strategy.     

Mathematical modeling of interaction between innate and adaptive immune responses in COVID-19 and implications for viral pathogenesis

We have applied mathematical modeling to investigate the infections of the ongoing coronavirus disease-2019 (COVID-19) pandemic caused by SARS-CoV-2 virus. We first validated our model using the well-studied influenza viruses and then compared the pathogenesis processes between the two viruses. The interaction between host innate and adaptive immune responses was found to be a potential cause for the higher severity and mortality in COVID-19 patients. Specifically, the timing mismatch between the two immune responses has a major impact on disease progression. The adaptive immune response of the COVID-19 patients is more likely to come before the peak of viral load, while the opposite is true for influenza patients. This difference in timing causes delayed depletion of vulnerable epithelial cells in the lungs in COVID-19 patients while enhancing viral clearance in influenza patients. Stronger adaptive immunity in COVID-19 patients can potentially lead to longer recovery time and more severe secondary complications. Based on our analysis, delaying the onset of adaptive immune responses during the early phase of infections may be a potential treatment option for high-risk COVID-19 patients. Suppressing the adaptive immune response temporarily and avoiding its interference with the innate immune response may allow the innate immunity to more efficiently clear the virus.     

The immune response in steroid deficient mice

Adrenalectomy, gonadectomy and combined adrenalectomy—gonadectomy resulted in increased spleen weights, spleen cell counts and 19S plaque-forming cells following primary and secondary immunization of mice with SRBC when compared to controls. Plaque-forming cells of the 7S type in the spleen did not increase when measured on the eleventh day following the primary or the third day following secondary sensitization. Combined adrenalectomy—gonadectomy had a greater effect on spleen cell counts, spleen weights and plaque-forming cells in the primary and secondary response than either operation alone. Haemolysin titres were not significantly different between test and sham operated animals in the primary and secondary responses.

In the primary responses, it appears that the increase in spleen weight and cell count is responsible for the increase in 19S plaque-forming cells. The response to a second injection of SRBC demonstrated that 19S antibody-producing cells increased three-fold in steroid depleted mice above the control values. In the test animals the 19S antibody-producing cells of the spleen were relatively enriched above that of the controls.

     

Parvovirus B19: a pathogen responsible for more than hematologic disorders

The clinical and pathomorphological patterns of parvovirus B19 (PVB19)-associated diseases is the result of a balance between virus, host target cells and immune response. It is a characteristic feature of PVB19 that in patients with various other preexisting diseases, e.g., many hemolytic anemias, immune complex-mediated vasculitic disorders, and primary or secondary immunodeficiencies, the underlying diseases can be triggered, aggravated or complicated by severe organ manifestations. Identification of PVB19 by means of routine histology and immunohistology is only given in lytic infections occurring in transient aplastic anemia or nonimmune hydrops fetalis by the detection of viral inclusion bodies in erythroid precursor cells. In all other PVB19-associated diseases, molecular pathological methods must be applied. In this report, quantitative real-time polymerase chain reaction was used to determine the viral load in formalin-fixed and paraffin-embedded tissues derived from various organs. Using in situ hybridization it was demonstrated that endothelial cells of the microcirculatory periphery of the heart and hepatobiliar system in lytic infections are PVB19-specific target cells in children and adults. Because treatment of lytic PVB19 infection has been successfully applied, the pathologist should be alerted to include PVB19 into the diagnostic spectrum of viral disease, especially in immunocompromised patients.     

Vitamin D analogs: perspectives for treatment

Vitamin D therapy is widely used for the treatment of secondary hyperparathyroidism associated with chronic renal failure. However, administration of 1,25-dihydroxyvitamin D(3) [1,25(OH)(2)D(3)] or its precursor 1alpha(OH)D(3), especially in combination with calcium-based phosphate binders, often produces hypercalcemia. Several vitamin D analogs have been developed that retain the direct suppressive action of 1,25(OH)(2)D(3) on the parathyroid glands but have less calcemic activity. These analogs offer a safer and more effective means of controlling secondary hyperparathyroidism. 22-Oxa-1,25(OH)(2)D(3) (22-oxacalcitriol or OCT), 19-nor-1, 25(OH)(2)D(2) (19-norD(2)) and 1alpha(OH)D(2) have been tested in animal models of uremia and in clinical trials. Intravenous 19-norD(2) and oral 1alpha(OH)D(2) have been approved for use in the United States; OCT is currently under review. The mechanisms by which these analogs exert their selective actions on the parathyroid glands are under investigation. The low calcemic activity of OCT has been attributed to its rapid clearance which prevents sustained effects on intestinal calcium absorption and bone resorption, but still allows a prolonged suppression of PTH gene expression. The selectivity of 19-norD(2) and 1alpha(OH)D(2) is achieved by a distinct mechanism(s). Knowledge of how these compounds exert their selective actions on the parathyroid glands may allow the design of more effective analogs in the future.     

Modulation of the immune response by a methanol-insoluble fraction of attenuated tubercle bacilli (BCG). I. Primary and secondary responses to sheep red blood cells and T2 phage

Studies were continued on the mode of action of a methanol-insoluble moiety (methanol-extraction residue) of attenuated tubercle bacilli which enhances the immune response. We analysed the effects of treatment with this material on the primary and secondary immune responses of mice to two antigens, sheep red blood cells and T₂ phage.

Pretreatment with methanol-extraction residue enhanced the primary response to sheep red blood cells, accelerating the formation of both 19S and 7S plaqueforming cells and of circulating haemagglutinins, and prolonging high levels of 19S and 7S plaque-forming cells.

Methanol-extraction residue delayed the secondary response to sheep red blood cells when administered between primary and secondary immunization. Methanolextraction residue administration subsequent to immunization did not affect an ongoing primary response to this antigen.

Administration of methanol-extraction residue before primary immunization with T₂ phage, or between primary and secondary immunizations, enhanced both the primary and secondary circulating antibody responses to this antigen.

The findings are discussed in relation to possible sites of action of methanol-extraction residue.

     

新型冠状病毒肺炎患者急诊科转运路径

2019年12月以来,武汉市暴发新型冠状病毒肺炎(COVID-19),并迅速蔓延至全国各地。为了有效防控疾病的蔓延,大部分省市均启动限制交通、出入等措施,这给患者的急诊转运流程带来了巨大的挑战。为了有效促使患者顺利入院接受救治,四川大学华西医院急诊科采用了一种创新医疗隔离运输系统以转运新型冠状病毒肺炎患者,并应用于首例患者的急诊转运,最终使该患者顺利入院,且转运途中病情稳定,按计划进行治疗,未发生二次感染病例。     

Genetic Alterations in Gliosarcoma and Giant Cell Glioblastoma

The majority of glioblastomas develop rapidly with a short clinical history (primary glioblastoma IDH wild‐type), whereas secondary glioblastomas progress from diffuse astrocytoma or anaplastic astrocytoma. IDH mutations are the genetic hallmark of secondary glioblastomas. Gliosarcomas and giant cell glioblastomas are rare histological glioblastoma variants, which usually develop rapidly. We determined the genetic patterns of 36 gliosarcomas and 19 giant cell glioblastomas. IDH1 and IDH2 mutations were absent in all 36 gliosarcomas and in 18 of 19 giant cell glioblastomas analyzed, indicating that they are histological variants of primary glioblastoma. Furthermore, LOH 10q (88%) and TERT promoter mutations (83%) were frequent in gliosarcomas. Copy number profiling using the 450k methylome array in 5 gliosarcomas revealed CDKN2A homozygous deletion (3 cases), trisomy chromosome 7 (2 cases), and monosomy chromosome 10 (2 cases). Giant cell glioblastomas had LOH 10q in 50% and LOH 19q in 42% of cases. ATRX loss was detected immunohistochemically in 19% of giant cell glioblastomas, but absent in 17 gliosarcomas. These and previous results suggest that gliosarcomas are a variant of, and genetically similar to, primary glioblastomas, except for a lack of EGFR amplification, while giant cell glioblastoma occupies a hybrid position between primary and secondary glioblastomas.     

Recommendations for antibacterial therapy in adults with COVID-19 – an evidence based guideline

ScopeThe Dutch Working Party on Antibiotic Policy constituted a multidisciplinary expert committee to provide evidence-based recommendation for the use of antibacterial therapy in hospitalized adults with a respiratory infection and suspected or proven 2019 Coronavirus disease (COVID-19).MethodsWe performed a literature search to answer four key questions. The committee graded the evidence and developed recommendations by using Grading of Recommendations Assessment, Development, and Evaluation methodology.Questions addressed by the guideline and RecommendationsWe assessed evidence on the risk of bacterial infections in hospitalized COVID-19 patients, the associated bacterial pathogens, how to diagnose bacterial infections and how to treat bacterial infections. Bacterial co-infection upon admission was reported in 3.5% of COVID-19 patients, while bacterial secondary infections during hospitalization occurred up to 15%. No or very low quality evidence was found to answer the other key clinical questions. Although the evidence base on bacterial infections in COVID-19 is currently limited, available evidence supports restrictive antibiotic use from an antibiotic stewardship perspective, especially upon admission. To support restrictive antibiotic use, maximum efforts should be undertaken to obtain sputum and blood culture samples as well as pneumococcal urinary antigen testing. We suggest to stop antibiotics in patients who started antibiotic treatment upon admission when representative cultures as well as urinary antigen tests show no signs of involvement of bacterial pathogens after 48 hours. For patients with secondary bacterial respiratory infection we recommend to follow other guideline recommendations on antibacterial treatment for patients with hospital-acquired and ventilator-associated pneumonia. An antibiotic treatment duration of five days in patients with COVID-19 and suspected bacterial respiratory infection is recommended upon improvement of signs, symptoms and inflammatory markers. Larger, prospective studies about the epidemiology of bacterial infections in COVID-19 are urgently needed to confirm our conclusions and ultimately prevent unnecessary antibiotic use during the COVID-19 pandemic.     

脾脏非霍奇金淋巴瘤的临床病理特征及其与免疫表型的关系

目的 探讨脾脏非霍奇金淋巴瘤（NHL）的临床病理特征及其与瘤细胞属性的关系。方法 复习19例NHL的临床病理资料、进行随访、并用SP法行CD45RO、CD20及髓过氧化物酶等免疫组织化学染色,对CD45RO阳性的病例加作CD8、CD56、TLA-1、CD68免疫表型检测和EBER原位杂交。结果 （1）19例均有脾脏肿大,其中52.6%(10/19)有脾脏占位病变,（2）73.7%(14/19)为B细胞性,滤泡型5例,经济危弥漫型9例;中心母细胞性8例,中心母细胞/中心细胞性3例,小细胞性4例,10例原发脾脏NHL均为B细胞性;（3）26.3%(5/19)为外周T细胞性,大细胞性4例,小细胞性1例;TLA-1阳性3例,其中CD8阳性和CD56阳性各1例,且均为EBNER1/2阳性,余1例为CD8、CD56、EBER均阴性;均为继发脾脏NHL;（4）73.7%(14/19)有随访,9例生存者中有8例为原发脾脏NHL,生存时间为8个月-10年不等;5例死亡病例均为继发脾脏NHL,生存时间为2-6个月不等。结论 脾脏NHL的临床病理表现与瘤细胞的属性有一定关系。原发脾脏NHL的预后明显优于继发脾脏NHL,对原发脾脏NHL的诊断应从严把握。