Isoelectric focusing pattern of IgM and surface markers in non-Hodgkin's lymphomas.
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Biomedical subjects
Publications and source records attributed to H Stein.
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The cells of four thymus glands, two at 12 weeks, one at 16 weeks and one at 22 weeks gestational age, were examined cytochemically for enzymic activity and for surface markers. The reactions for chloroacetate esterase, peroxidase, and alkaline phosphatase were negative and the reaction for nonspecific esterase was only weakly positive in some of the cells. In contrast, nearly all thymocytes at the 12th gestational week showed strong focal acid phosphatase (acP) activity. The number of acP-stainable cells and the staining intensity declined progressively. A high percentage of thymocytes in early fetal life express a complement receptor (CR); the proportion of CR-bearing cells decreased while cells forming rosettes with sheep erythrocytes (possessing erythrocyte receptors: ER) correspondingly increased during fetal life. Using a mixed rosette assay, up to 30% of the thymocytes at 12 weeks gestation were found to bear CR and ER simultaneously. The number of CR- and ER-positive cells also declined progressively with fetal age. These findings show that CR-positive, ER-negative thymus cells mature into CR-negative, ER-positive thymocytes via a CR-positive and ER-positive intermediate cell, indicating that mature ER-positive thymocytes do not originate from another cell line lacking CR. The changes in surface markers during early T cell maturation is relevant to certain lymphomas whose cells also show strong focal acP activity and also express both CR and ER. These lymphoma cells may correspond to fetal thymocytes or T precursor cells present in small numbers after birth.
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29 cases of T-cell derived lymphoblastic lymphoma and T-ALL have been analyzed. There is a striking prevalence of the male sex. In the peripheral blood we often find initially an excessive number of white blood cells combined with normal values for the other constituents in about half of the patients; This may be an expression for the rapid occurrence of leukaemia in T-cell lymphosarcoma. In addition to systemic ALL-therapy we performed X-ray irradiation of the mediastinum in 8 of our patients. This yielded to significantly longer first complete remissions. All patients with T-cell LSA/ALL with or without mediastinal mass should be treated in this manner. Cytochemically a strong focal acid phosphatase reaction was found to be acharacteristic of these cells. It has proved to be a screening method for this disease. The cells are T-cell derived and their pattern of surface markers is similar to that found in fetal thymocytes.
405 cases with non-Hodgkin's lymphomas have been diagnosed according to the Kiel classification and analysed retrospectively. 314 patients with non-Hodgkin's lymphomas of low-grade-malignancy (chronic lymphocytic leukemia, lymphoplasmacytoid, centrocytic, centrocytic, centroblastic-centrocytic lymphoma) manifested significantly higher median survival times than the 91 patients with non-Hodgkin's lymphomas of high-grade malignancy (lymphoblastic and immunoblastic lymphoma). Within the group of patients with low-grade malignant lymphomas distinct prognostic differences were found whereas survival times in patients with lymphoblastic or immunoblastic lymphomas were rather similar. The lymphoblastic lymphoma showed a bimodal curve of age distribution whilst all other lymphomas had a maximum of incidence in the seventh decade of life. Increased frequency of B-symptoms did not necessarily represent an unfavorable prognostic factor for the lymphoma entity concerned. Except for chronic lymphocytic leukemia the highest incidence of initial bone marrow involvement was seen in lymphoplasmacytoid, centrocytic and lymphoblastic lymphomas. Centrocytes have been observed in peripheral blood of patients with centrocytic and centroblastic-centrocytic lymphomas, even though lymphocytosis did not exist. Monoclonal hypergammaglobulinemia was found in only 43% of the sera from patients with lymphoplasmocytoid lymphoma. In this disease, it was possible to differentiate between a lymphonodal, a splenomegalic and an extranodal manifestation.
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Five lymphatic neoplasms with strong focal acid phosphatase reactivity were selected from a group of acute lymphocytic leukemias and lymphoblastic lymphomas. All five cases showed an anterior mediastinal mass and exhibited identical morphology. This type of lymphoma has been described by Lukes under the term "malignant lymphoma of convoluted lymphocytes". Analysis of surface membrane receptors revealed that the tumor cells lacked surface immunoglobulin and receptors for Fc-fragment, but possessed receptors for complement (C3), untreated SRBC (ES) and SRBC treated with neuraminidase (ESN). By applying a mixed rosette assay using nucleated chicken erythrocytes coated with antibodies and C3, and denucleated ESN, it was found that a considerable number of tumor cells in all five cases formed mixed rosettes, i.e. that they bore the C3 receptor characteristic of B cells and simultaneously the E receptor characteristic of T cells. Thus the tumor cells resembled immature thymocytes of 10-15 weeks' gestation, which also show focal acid phosphatase reactivity and simultaneous expression of C3 and E receptors.
Various biopsies from different European malignant lymphomas, two biopsies from nasopharyngeal carcinomas, and material from non-neoplastic lymph nodes were assayed for the presence of Epstein-Barr virus (EBV) DNA by nucleic acid hybridization. Reassociation kinetics of in vitro-labelled EBV DNA were studied in the presence of tumor DNA. The lymphomas tested included among others follicular lymphomas, germinocytomas, immunoblastic lymphomas and lymphoplasmacytoid immunocytomas. Epstein-Barr viral DNA was demonstrated within the two nasopharyngeal carcinoma biopsies as expected. A histologically typical Burkitt lymphoma as well as an immunoblastic lymphadenopathy with excessive plasmacytosis also contained EBV-DNA. The Burkitt biopsy revealed about 15 EBV genome equivalents per cell. Antibodies against EBV-specific antigens were highly elevated in the serum of this patient. The material of the patient with immunoblastic lymphadenopathy contained 2-3 EBV genome equivalents per cell.
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Rabbits and rats were given single injections of aurothiomalate by different routes. The animals were killed at progressive intervals, and sections from various organs were examined by electron microscopic x-ray microanalysis. Ultrastructurally, characteristic material was regularly found in vacuoles, dense and heterogeneous bodies of macrophages, hepatocytes and renal epithelial cells. Occasionally, other mesenchymal cells also contained gold. Histochemical and analytical tests showed that the gold-containing organelles were devoid of acid phosphatase activity. The generalized rapid spread, retention and selectivity of localization after a single small dose make aurothiomalate a useful marker substance for ultrastructural studies.
The results of ten excision arthroplasties of the elbow for rheumatoid disease are described. The operation may afford good relief of pain and a useful increase both of hinge motion and of forearm rotation. Instability is not a serious problem unless the patient has to bear weight on crutches. To increase stability after arthroplasty it appears that Kirschner wire fixation is advisable as well as a plaster cast. For advanced rheumatoid disease unilateral excision arthroplasty has a definite value, especially for patients confined to a wheelchair.