CORRELATION OF IMMUNOLOGICAL SURFACE ANTIGENS WITH SURVIVAL IN DIFFUSE LARGE CELL LYMPHOMA

The prognostic value of immunophenotyping lymphomas with a panel of monoclonal antibodies (Mab) to various lymphoid antigens was assessed by studying 47 cases of diffuse large cell lymphoma. Cell suspensions were analysed by flow cytometry after labelling by indirect immunofluorescence. Thirty-eight cases were demonstrated to be of B cell and nine of T cell phenotype. Univariate analysis demonstrated that survival was significantly longer in patients expressing higher levels of HLA-DR (p=0·01) and normal levels of CD8 (p=0·04) but was not significantly associated with any of the other antigens. Our results support the possible value of HLA-DR in determining the prognosis of patients with diffuse large cell lymphoma.     

Functional plasticity of microglia: a review

The present review summarizes recently acquired data in vivo, which support a role of CNS microglia as a source of defense cells in the CNS capable of carrying out certain immune functions autonomously. We have kept the following discussion restricted to microglial cells and have not included work on the immunological functions of astrocytes, which has been recently reviewed elsewhere (Fontana et al.: Immunological Reviews 137:3521-3527, 1987). Resting microglia are scattered uniformly throughout the CNS forming a network of potential immunoeffector cells, which can be activated by stimuli ranging from peripheral nerve injury over viral infections to direct mechanical brain trauma. The term "activated microglia" is used here to describe proliferating cells that demonstrate changes in their immunophenotype but have not undergone transformation into brain macrophages. Such a transformation can be stimulated by neuronal death but not by sublethal neuronal injury. Microglia may function as antigen-presenting cells and may thus represent the effector cell responsible for the recruitment of lymphocytes to the brain resulting in an inflammatory reaction. The recent developments in the understanding of microglial cell function may lead to a redefinition of the often cited "immune privilege" of the brain.     

Eosinophilic granuloma of lymph node: case report with cytohistologic, immunohistochemical, and flow cytometric observations

A case study of eosinophilic granuloma (Langerhans cell histiocytosis) of lymph node in a 32-year-old white man is presented. Clinical, cytologic, histologic, immunohistochemical, and flow cytometric findings are reported. Intraoperative cytologic findings can serve as valuable adjuncts to the frozen section, in this case serving as the sole method for diagnosis. This case is presented in light of the rarity of node-based eosinophilic granuloma and the absence of flow cytometric immunophenotypic findings in the literature.     

Pyothorax-associated lymphoma: an unusual case with both T- and B-cell genotypes

Pyothorax-associated lymphoma (PAL) is a B-cell lymphoma which develops in the pleural cavity of patients with an over-20-year history of pyothorax. Aberrant expression of surface antigens is occassional in PAL, although genotype is not fully investigated. We report here a PAL with dual genotype, i.e., simultaneous immunoglobin (Ig) and T-cell receptor (TcR) gene rearrangement. An 82-year-old woman with pain on the left side of the chest was admitted. She had been suffering from pyothorax after artificial pneumothorax for treatment of tuberculosis of the pulmonary when she was 18 years old. The mass that was confined to the left pleural cavity affected by pyothorax was biopsied and histologically diagnosed as diffuse large cell lymphoma. The tumor cells were positive for CD20, CD16, and TIA-1 but negative for CD79a, CD45RO, CD43, CD3, and CD56. Surface antigen expression was further investigated in cultured cells, showing that the cultured cells did not express representative B-cell markers, except for CD20, as well as T-cell markers, but were positive for CD16, CD30, and CD103. Southern blotting revealed the monoclonally rearranged bands of both Ig heavy chain and TcR gene. The patients died of tumors 14 months after admission. Aberrant genotype and immunophenotype of PAL cells is discussed in reviewing the pertinent literature.     

睾丸原发性恶性淋巴瘤——附10例报道

目的报道10例睾丸原发性恶性淋巴瘤,并分析其临床表现、形态学牲及免疫表型。方法 采用HE及免疫组织化学方法,对标本切片进行染色,显微镜观察分析。结果患年龄为38～76岁,中位年龄56．25岁。临床表现主要为睾丸无痛性弥漫性肿大。病变部位：右侧5例,左侧4例,双侧1例。组织学形态均为恶性弥漫性非霍奇金淋巴瘤,免疫表型B细胞来源9例,T细胞来源1例。结论睾丸弥漫性无痛性肿大在中老年患应考虑睾丸原发性恶性淋巴瘤的可能,最后确诊要依靠病理形态学及免疫组织化学来证实。     

Hepatosplenic γδ T-cell lymphoma

AIM: To investigate the clinicopathologic characteristics, immunophenotype and TCR gene rearrangements of hepatosplenic T-cell lymphoma in eight Chinese patients. METHODS: Eight Chinese patients with hepatosplenic 76 T-cell lymphomas were studied. Hematoxylin-eosin-stained slides and clinical histories were reviewed. We also carried out immunohistochemical staining for CD3, CD4, CD8, CD20, CD43, CD56, CD79a, UCHL-1, and TCR γδ. Rearrangements of TCR gamma and delta chain genes were also studied. RESULTS: The spleens were enlarged and the cut surfaces were homogeneous and red-purple in color without identifiable gross lesions or enlarged hilar lymph nodes. Histologically, lymphoma cells infiltrated the cords of Billroth and often packed the sinuses. Liver biopsy showed lymphoma cell infiltrations in the sinusoids, and three cases showed involvements of the portal tracts. Immunohistochemically lymphoma cells were positive for CD3, CD43, and CD56 in all cases. Four of eight cases were positive for CD8, and all cases were negative for CD4 (6/6). Monoclonal rearrangements of TCR y gene were demonstrated by PCR analysis in five out of the eight cases. TCR δ gene rearrangements were detected in six out of the eight cases, which demonstrated single bands on PAGE gel, and the amplification products in two cases were confirmed by sequencing. CONCLUSION: The clinicopathology of hepatosplenic γδ T-cell lymphoma in Chinese patients is similar to what was previously reported except that the splenomegaly is not so massive, and CD8 is positive.     

CD66 expression in acute leukaemia

Antibodies against CD66 identify antigens from the carcinoembryonic antigen (CEA) family of proteins, which belong to the immunoglobulin gene superfamily. Despite being usually restricted to cells of myeloid or monocytic origin, CD66 expression has also been reported in blasts from children with B-cell lineage acute lymphocytic leukaemia (ALL). An analysis of the CD66 expression was undertaken in a series of acute leukaemia patients. Antigenic expression was analysed using triple combinations of monoclonal antibodies (mAbs) in forty-five patients. The CD66 Kat4 fluorescein isothiocyanate clone was purchased from Dako (Glostrup, Denmark). CD66 was expressed in 2 of 29 patients with AML (acute myeloblastic leukemia) (6.8%) and in 8 of 12 patients with B-cell lineage ALL (66.7%; P <0.001); in blast crisis (BC) of chronic myelocytic leukaemia (CML), CD66 was expressed in two patients with lymphoid BC but not in the two with myeloid BC. The co-expression of CD66 with other myeloid antigens was observed in all CD66+ ALL/Ly-BC cases tested: CD 13 in six patients, CD33 in seven and CD117 in two patients. The CD66 expression is more frequent in ALL than in AML. Furthermore, we analysed minimal residual disease (MRD) in eight patients in complete remission. CD66 expression was associated with an abnormal B-cell differentiation pattern and with increases in CD34/CD19+ cells in all but one case. These findings suggest that an aberrant expression of CD66 could be used to investigate MRD in ALL. The association between CD66 reactivity and bcr-abl in adult ALL remains to be investigated. Received: 31 May 1999 / Accepted: 10 November 1999     

T、B免疫双标记型急性淋巴细胞白血病的临床特点

目的 :了解T、B免疫双标记型急性淋巴细胞白血病 (ALL)的临床特点 ,以判断预后与指导治疗。方法 :对 4 89例形态学上诊断为ALL的病例 ,取其外周血或骨髓 ,分离出单个核细胞 ,应用APAAP法进一步作免疫表型分析 ,对其中同时表达T、B淋巴细胞表面抗原的免疫双标记型病例的临床特点、化疗疗效及预后进行观察。结果 :4 7例患者同时表达T、B淋巴细胞表面特异性抗原。在临床方面 ,与T淋巴细胞系ALL相比 ,肝、脾、淋巴结肿大或纵隔肿块发生率、白细胞数量均较低 (P <0 .0 5 ) ,但化疗完全缓解率及存活期差异无显著性意义(P >0 .0 5 ) ;与B淋巴细胞系ALL相比 ,肝、脾、淋巴结肿大及纵隔肿块发生率均较高 (P <0 .0 5 ) ,而白细胞数量差异无显著性意义 (P >0 .0 5 ) ,但化疗完全缓解率高、存活期较长 (P <0 .0 5 )。结论 :免疫双标记型ALL在临床上可能属预后较好的造血系统肿瘤     

CD56-多发性骨髓瘤患者临床特征及预后分析

目的探讨CD56-多发性骨髓瘤(MM)患者临床特征及预后。方法回顾性分析48例新发MM患者的临床资料、实验室检查资料及治疗方案,比较CD56-MM患者与CD56+MM患者临床特征及预后。结果 48例MM患者中,CD56-MM患者14例(29%),CD56+MM患者34例(71%)。比较CD56-MM与CD56+MM患者在发病年龄、性别、临床分期方面无明显差异;两组患者均以骨痛、骨质疏松、病理性骨折、贫血、感染为最常见首发症状,CD56+MM患者骨痛的发生率明显高于CD56-MM患者(P<0.05),其他临床表现和起病方式上无明显差异;反映疾病进展程度的指标,如血红蛋白、血小板、血清钙、免疫球蛋白水平、血肌酐水平及24h尿蛋白定量两组比较无明显差异(均P>0.05);反映预后相关因素如骨髓浆细胞数量、β2-微球蛋白、C-反应蛋白、血沉水平两组比较亦无明显差异(均P>0.05);CD56-MM患者多发骨质破坏发生率明显低于CD56+MM患者(64.3%vs 91.2%,P<0.05);对两组患者进行生存期分析,CD56-MM和CD56+MM患者中位生存期分别为14.7个月和15个月,两组比较无统计学差异(P=0.348)。结论 CD56-MM患者骨痛和骨质破坏的发生率明显低于CD56+MM患者,其它临床特征及预后指标与CD56+MM患者比较无明显差异。     

慢性淋巴细胞白血病CD5漏检临床案例分析及对策

目的分析不同荧光素标记抗体对慢性淋巴细胞白血病(CLL)B细胞表面CD5检测结果差异及其对临床诊断的影响。方法采用流式细胞仪检测3例CD5表达强度不同的慢性淋巴细胞白血病(CLL)患者的免疫表型,采用SYSMEX XE2100全自动血液分析仪检测血常规;以1例急性B淋巴细胞白血病(B-ALL)患者作为阴性对照。结果采用异硫氰酸荧光素(FITC)标记抗体检测4例患者骨髓异常B淋巴细胞CD5表达,CD5阳性细胞未见独立成群,阳性细胞比例分别为47.1%、17.7%、6.7%和7.9%;以≥20%为标准,仅病例1阳性。以PE-Cy7荧光素标记抗体重新检测,病例1和2的CD5阳性细胞独立成群,病例3 CD5表达呈连续表达模式,阳性细胞比例分别上升至91.1%、70.3%和38.2%。而对照病例4(B-ALL患者)2次检测CD5比例均为阴性。病例1、2、3符合典型CLL免疫表型。结论 CLL患者B细胞表面常异常表达CD5,但其表达强度显著低于T细胞表面CD5表达。采用弱荧光素标记抗体检测B细胞表面CD5表达,会出现漏检进而影响临床诊断。对弱表达抗原选择合适的荧光素标记,并进行验证和比对确定其准确性,是正确提供疾病免疫表型的重要保障。