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Biomedical subjects

A G Stansfeld

Publications and source records attributed to A G Stansfeld.

At least 37 records · Page 2Linked to original sources
PubMed1988

A comparison of nucleolar organizer region staining and Ki-67 immunostaining in non-Hodgkin's lymphoma.

Eighty cases of non-Hodgkin's lymphomas were examined independently using the monoclonal antibody Ki-67 and an argyrophilic method for the demonstration of nucleolar organizer regions. The evidence that Ki-67 immunoreactivity may be used as a marker of cell proliferation is described and the nature of nucleolar organizer regions reviewed. The proportion of tumour cells with nuclear Ki-67 immunoreactivity and the mean number of nuclear organizer regions are shown to be linearly related (r = 0.86, P less than 0.001) although some scatter was observed. These data suggest that the mean number of nucleolar organizer regions may reflect the cellular kinetics of a tumour. This study also provides further evidence supporting the thesis that the mean nucleolar organizer region score is related to the histological grade of non-Hodgkin's lymphoma. Ki-67 immunostaining and nucleolar organizer region staining would seem to provide comparable data, at least in non-Hodgkin's lymphoma, but the latter method has the advantage of being applicable to conventionally fixed and processed paraffin sections.

Antibodies, Monoclonal↗
PubMed1988

Paraffin section immunohistochemistry. I. Non-Hodgkin's lymphoma.

Reagents that recognize antigens on lymphoid cells in fixed and wax-embedded sections have been applied to a series of cases of non-Hodgkin's lymphomas. The panel consisted of MB1, 4KB5 (CD45r), LN1, L26 and MB2 which recognize antigens expressed predominantly on B-lymphocytes; UCHL1 and MT1 which recognize antigens expressed on T-lymphocytes and myeloid cells; antibodies recognizing the non-lineage antigens LeuM1 (CD15), BerH2 (CD30), anti-EMA; anti-lysozyme and MAC 387 which detect antigens present on some macrophages; and finally TAL1B5 (class II MHC), CAM 5.2 (low molecular weight cytokeratin) and PD7/26 + 2B11(CD45). Two hundred and four cases of non-Hodgkin's lymphoma have been studied, of which 158 had been fully characterized on frozen sections. The series was biased towards high-grade (n = 108) and T-cell (n = 44) tumours and these were largely prospectively accrued. It was found that discrimination between B-cell and T-cell lymphomas can be reliably achieved using these reagents and that a small panel (CD45, L26, MB2, MT1, UCHL1) is adequate for this purpose. Using the full range of reagents it is not possible to subdivide cases into groups that correspond with morphological subtypes of lymphoma. Although paraffin section immunohistochemistry is of value, the diagnosis of lymphoproliferative disorders must still be based upon the assessment of well fixed, carefully prepared tissue sections using conventional tinctorial methods.

Antibody Specificity↗
PubMed1988

Paraffin section immunohistochemistry. II. Hodgkin's disease and large cell anaplastic (Ki1) lymphoma.

A panel of antibodies that recognize antigens that survive fixation and conventional processing have been applied to 43 cases of Hodgkin's disease and five cases of large cell anaplastic lymphoma. Reed-Sternberg cells in all five cases of nodular lymphocyte predominance Hodgkin's disease were positive with leucocyte common (CD45) and B-cell antibodies, and negative with LeuM1 (CD15) and BerH2 (CD30) antibodies. In other types of Hodgkin's disease, Reed-Sternberg cells were positive with BerH2 in all cases, positive with LeuM1 in 63% of cases (with enzymic predigestion), positive with at least one B-cell antibody in 29% of cases and positive for CD45 in 8% of cases. In 19% of all cases, Reed-Sternberg cells were positive for epithelial membrane antigen and in 93% they were positive with TAL1B5 (anti-class II MHC). No case showed immunoreactivity with anti-T-cell antibodies. The patterns of immunoreactivity of large cell anaplastic lymphoma were similar, except that none was positive with B-cell antibodies and three were positive with T-cell antibodies. All five were positive with BerH2 (CD30) and TAL1B5. Comparison of the results with those seen in other cases of non-Hodgkin's lymphoma indicates that, with the currently available reagents, this immunohistological profile cannot be used as the sole diagnostic discriminant of these conditions; this must still be based upon careful morphological assessment.

Antigens, Surface↗
PubMed1988

Extensive necrosis in malignant lymphoma with granulomatous reaction mimicking tuberculosis.

Epithelioid cell granulomas occur in association with a wide range of neoplasms but necrotizing granulomas mimicking tuberculosis are less well recognized. Two cases of high-grade malignant lymphoma of Burkitt type are presented which were associated with such a response. In both cases this caused difficulty in interpretation and in one led to delayed diagnosis. Regional lymph nodes were not involved by lymphoma but contained epithelioid cell granulomas in both cases. Features that suggested that the granulomatous reaction was related to the tumour included a close spatial relation, the reticulin pattern in the areas of necrosis and the immunohistochemical demonstration of lymphoid antigens in the necrotic debris. A diligent search for mycobacteria and other micro-organisms failed to reveal any infective cause. We suggest that the local granulomatous response is a reaction to the presence of necrotic and poorly viable tumour and the granulomas in nearby lymph nodes may be a response to tumour derived debris.

Animals↗
PubMed1987

Lymphoplasmacytoid lymphoma: an immunohistological study.

Eighteen cases of lymphoplasmacytoid lymphoma (LPL) have been immunophenotypically characterized with a panel of 26 monoclonal antibodies. All cases expressed leucocyte common antigen, class II MHC and stained with B cell markers (CD19, CD20, CD22) although a variable proportion of tumour cells were noticed to have lost some B cell marker expression. There was some phenotypic heterogeneity with variable immunostaining with KB61, CD21, and CD5. A variable proportion of cells in all cases contained cytoplasmic immunoglobulin. Surface immunoglobulin light chain restriction was demonstrated in 11 cases and heavy chain predominance in 16 cases. Few tumour cells were proliferating as indicated by Ki67 immunostaining. A wide variation in number of macrophages and T lymphocytes were present in association with the tumours. A significant association between the expression of CD5 and the presence of peripheral blood lymphocytosis was noticed (p less than 0.003) but there was no association between CD5 and co-expression of IgM and IgD. This data supports an origin from non-germinal centre cells for LPL and suggests that CD5 expression by B cells may be related to lymphocyte migration. LPL shows some immunological heterogeneity and can present diagnostic difficulties, but its poor prognosis makes it an important category of lymphoma to recognise.

Antigens, Differentiation, B-Lymphocyte↗
PubMed1987

Angio-immunoblastic lymphadenopathy: a clinical, immunological and molecular study.

Twenty four patients with angio-immunoblastic lymphadenopathy (AILD) presenting between 1974 and 1985 have been reviewed. Clinical features at presentation included rash, fever, lymphadenopathy and hepatosplenomegaly in 75% of patients. Polyclonal hypergammaglobulinaemia was seen in 19/20 patients; 5 had normal immunoglobulin levels. Combination chemotherapy with MVPP was the optimal treatment with 6/7 patients achieving complete remission. Duration of remission ranged from 9 months to 4 years and was significantly longer in patients achieving complete as opposed to partial remission. In 6 patients phenotype studies were performed on single cell suspensions and immunoperoxidase studies on frozen sections of 7 lymph nodes. There was a reversal of the normal T suppressor/helper cell ratio with a predominance of T suppressor cells. Loss of normal B follicles was observed histologically in all except one lymph node. Germline configuration of the beta B-chain of the T cell receptor was observed in lymph nodes of 4 patients with AILD, and a rearranged T cell receptor was observed in 1 patient in whom a second lymph node biopsy had shown alteration of the histological picture to that of T-zone lymphoma. Frozen sera of 15 patients were screened for antibodies to HTLV I and III and were found to be negative.

Adult↗
PubMed1987

Malignant lymphoma with eosinophilia of the gastrointestinal tract.

Lesions of the gastrointestinal tract with massive tissue eosinophilia may present a difficult diagnostic problem. In a series of 250 gastrointestinal lymphomas drawn from the files of St Bartholomew's and St Mark's Hospitals there were 28 cases of a lymphoma with distinctive histological features, characterized by a massive tissue eosinophilia. Two of these tumours were present in the stomach and 26 in the small intestine. Eight of the latter were associated with coeliac disease. On low power examination a zoning phenomenon was regularly seen and fissuring ulceration, with perforation and fistula formation, was a common finding. The tumour cells were large and pleomorphic with irregular nuclear morphology and prominent nucleoli. Eosinophils were the predominant inflammatory cell associated with the lymphoma but plasma cells, epithelioid histiocytes and small lymphocytes were also present. Vascular changes were prominent. Involved lymph nodes showed gross expansion of the paracortex by tumour. Immunohistochemical studies showed that this lymphoma was probably of T-cell origin.

Aged↗
PubMed1987

New marker of B lymphocytes, MB2: comparison with other lymphocyte subset markers active in conventionally processed tissue sections.

The use of the murine monoclonal antibody MB2 for identifying B lymphocytes in routinely processed tissue was evaluated and contrasted with the use of the monoclonal antibody UCHL1 for identifying T cells. One hundred and sixty eight surgical biopsy specimens were immunostained with these antibodies, including a wide range of normal and neoplastic non-lymphoid tissues, as well as normal lymphoreticular tissues and lymphomas. Sixty four non-Hodgkin's lymphomas were also examined, of which 51 had been previously phenotypically defined. In selected cases the results were compared with those obtained using two other monoclonal antibodies MB1 and MT1, used for identifying B and T cells, respectively, in paraffin sections. MB1 stained a smaller proportion of B cell tumours than MB2 and staining was, in general, weaker, except in one case of centroblastic lymphoma. MT1 immunoreactivity was comparable with that of UCHL1, except in one case of T lymphoblastic lymphoma (MT1 positive, UCHL1 negative). None of the antibodies is ideal, but, if used as a panel, they permit the separation of B cells and T cells in paraffin sections.

Antibodies, Monoclonal↗
PubMed1987

Unusual myeloid leukaemia in patient with Hodgkin's disease.

An unusual case of leukaemia in a patient with Hodgkin's disease is described. The leukaemic blast cell population was typified by the presence of a substantial proportion of binucleate and multinucleate cells, many of which had the morphological features of Sternberg-Reed cells. The circulating and bone marrow blast cells were shown by immunophenotyping to be of myeloid origin.

Hodgkin Disease↗
PubMed1987

Histopathology and immunohistochemistry of peripheral T cell lymphomas: a proposal for their classification.

Based on the results of histological and immunohistochemical observations of a large number of peripheral T cell lymphomas from China, England, Germany and Japan, histological and cytological morphology were correlated with immunophenotype, aetiological association with HTLV-1, and clinical behaviour to produce a working classification of the T cell lymphomas. This classification, based mainly on cytological criteria, divides the peripheral T cell lymphomas into tumours of low grade and high grade malignancy. Adult T cell lymphoma/leukaemia (ATLL) is caused by HTLV-1 and belongs chiefly to the high grade category. Some tumours are characterised by an admixture of other cells (epithelioid cells, follicular dendritic cells, etc) and structures (high endothelial venules, follicles), which may indicate the secretion of lymphokines by the tumour cells. Clear cells seem to be specific for T cell lymphomas and may occur in various types of peripheral T cell lymphoma.

Adult↗
PubMed1986

Lymph-node infarction and malignant lymphoma: a multicentre survey of European, English and American cases.

A multicentre study of 51 cases of lymph-node infarction seen in the 30-year period 1956 to 1985 was conducted in order to assess both the short- and long-term prognostic implications of the condition. In 14 cases malignant lymphoma was found synchronously with the infarct. Of the remaining 37 patients with apparently 'benign' lymph-node infarction only six showed manifestations of malignant lymphoma in the follow-up time studied (mean = 48 months; range 1-156 months). These subsequent malignant lymphomas all occurred within 2 years of the lymph-node infarction. A postal enquiry and collation of other cases in the medical literature indicates that a minority (26 of 81) have developed malignant lymphoma, and that these lymphomas, too, have all appeared within 2 years. Thorough examination of both the infarcted lymph nodes and others resected at the same time is mandatory in order to exclude concomitant or underlying malignant lymphoma. Two years after lymph-node infarction the risk of malignant lymphoma is negligible.

Adolescent↗
PubMed1986

Follicular lymphoma: prognostic factors for response and survival.

One hundred forty-eight patients with newly diagnosed follicular lymphoma were treated over a 12-year period. Twenty-two patients received radiotherapy for stage I and II disease, followed by adjuvant chemotherapy in 14 patients. One hundred thirteen were treated at presentation with short courses of chemotherapy, most often with single-agent chlorambucil for bulky stage II and stages III and IV disease. Thirteen patients were managed expectantly until there was evidence of disease progression. The median survival was 9 years. Patients treated with radiotherapy for stage I and II disease had an 83% relapse-free survival, but those with bulky stage II or stages III and IV disease treated with chemotherapy pursued a remitting and relapsing course with a 70% response rate at initial and subsequent retreatments, but a median duration of remission of 4 years in stage III and 1 year in stage IV disease (P = .041). Patients were observed in relapse and retreatment was administered as appropriate, once every 33 months on average. Poor prognosis patients could be identified by a combination of the presentation characteristics: B symptoms, hepatosplenomegaly, anemia, and abnormal liver function. These factors predicted a poor response to treatment and correlated with a short survival. Histologic subgroups were not associated with differences in survival, but transformation to a diffuse high-grade lymphoma was observed in 23 of the 72 patients (32%) at risk, with a median follow-up of 6 years and 6 months, and was associated with a very poor prognosis. The present treatment strategy has proved successful for most patients with localized disease and those older patients with indolent small volume disseminated follicular lymphoma. New approaches are being investigated for the younger poor prognosis patients.

Adult↗
PubMed1985

HTLV-positive and -negative T-cell lymphomas. Morphological and immunohistochemical differences between European and HTLV-positive Japanese T-cell lymphomas.

A total of 56 cases of malignant lymphoma presumed to be of peripheral T-cell origin were investigated with regard to histological and immunohistochemical features. The goal of the study was to determine whether virus-associated T-cell lymphomas can be morphologically or immunohistochemically distinguished from presumably virus-negative T-cell lymphomas. The cases came from endemic and non-endemic regions of Japan, the United Kingdom (including 4 Caribbean cases) and the Federal Republic of Germany. Sera of all Japanese and Caribbean patients and 8 German patients were tested for antibodies to adult T-cell leukaemia virus-associated antigen HTLV-A. In all cases sections were examined blind by 5 well-trained histopathologists. In most cases cryostat sections could be prepared from fresh tissue specimens and stained with a large panel of monoclonal antibodies. All HTLV-A-positive cases were morphologically classifiable as the pleomorphic type of T-cell lymphoma. Approximately 70% of the tested cases of pleomorphic T-cell lymphoma, however, showed a positive serum reaction for HTLV-A. All other types of peripheral T-cell lymphoma (T-immunoblastic lymphoma, chronic lymphocytic leukaemia of T type, T-zone lymphoma, "AILD type" and lymphoepithelioid cell lymphoma) were HTLV-A-negative and mostly observed in European patients. Thus virus-associated T-cell lymphomas appear to be invariably of the pleomorphic type; but pleomorphism is not specific to HTLV-A-positive cases. This was also evident from the results of an experiment in which 2 Japanese histopathologists attempted to recognize HTLV-A positivity in a blind study of pleomorphic T-cell lymphomas. A maximum of about 80% of cases were correctly identified, with about 10% false-positive diagnoses (in HTLV-A-negative or presumably negative cases) and 10% false-negative diagnoses. The immunohistochemical analysis revealed not only many common features but also 2 distinct differences between HTLV-A-positive and -negative T-cell lymphomas. All but one of the HTLV-A-positive cases showed reactivity with anti-Tac and all cases in the virus-positive group were negative for TU14. All other cases were Tac-negative and approximately 65% of these cases exhibited reactivity with TU14. Preliminary cytogenetic observations suggest that there are also differences in specific chromosome aberrations.

Antibodies, Monoclonal↗
PubMed1985

T lymphoblastic lymphoma with LEU-7 positive phenotype and unusual clinical course: a multiparameter study.

Immunologic phenotype studies were performed on cells and on frozen sections of involved tissue from a 20 year old female with typical T-cell lymphoblastic (convoluted) lymphoma. The cells demonstrated a thymic phenotype but in addition marked with Leu-7 (HNK-1)--an antibody reported to identify human natural killer/killer (NK/K) cells. Normal or neoplastic cells with this phenotype have not been previously reported. These findings support the existence of a thymic precursor for a T-cell subset of Leu-7 + cells. The unusual clinical response to therapy is another feature of this unique case.

Adult↗
PubMed1985

B- and T-cell subsets in follicular centroblastic/centrocytic (cleaved follicular center cell) lymphoma: an immunohistologic analysis of 26 lymph nodes and three spleens.

Follicular centroblastic/centrocytic (CB/cc/F), or cleaved follicular center cell, lymphomas are known to contain admixtures of B cells and, often, numerous T cells. To analyze the presence and distribution of B and T cells and their subsets in CB/cc/F lymphomas, 26 lymph nodes and three spleens (from 24 patients) were studied with a panel of monoclonal antibodies and peanut lectin by the avidin-biotin immunoperoxidase technique on frozen sections. Immunoglobulin studies revealed monoclonal neoplastic follicles in most cases, although cells of the nondominant light chain were occasionally present. Rarely, the follicles showed both kappa and lambda light chains or were immunoglobulin-negative. Although monoclonal mantles were observed in only one case, more than half of the nodes demonstrated monoclonal interfollicular infiltrates. In most cases the phenotype of the follicular cells was similar to that of the predominant cells in the normal follicles. Interfollicular lymphomatous cells had variable phenotypes that, unlike the normal situation, sometimes resembled those in the follicles. Phenotypic variation was present within single neoplastic clones and sometimes suggested more mantle-like differentiation. Phenotypic changes were also observed in repeat biopsies. T cells, usually predominantly of the T-helper phenotype, were present in variable numbers in all cases. Although present in the neoplastic follicles, they were usually more common in the interfollicular areas. Six nodes and two spleens had definite rims composed predominantly of T cells around neoplastic follicles. Apparently "activated" (Tac-positive) T cells were often present and showed accentuation around the follicles in some cases. Thus, CB/cc/F lymphoma is a malignant lymphoma that closely resembles follicular hyperplasia but that also has distinctive features.

Antibodies, Monoclonal↗
PubMed1985

Cutaneous malignant histiocytosis--a clinicopathological review of five cases.

Malignant histiocytosis is a rare, and usually fatal, tumour which may involve the skin. The clinical and pathological changes are described in five patients who presented with skin nodules as the initial feature. We witnessed spontaneous healing of lesions, a previously described phenomenon which may cause diagnostic confusion. It is suggested that patients presenting with malignant histiocytosis confined to the skin form a sub-group with a more favourable prognosis.

Adult↗