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PubMed1995

AIDS-related Burkitt's lymphoma. Morphologic and immunophenotypic study of biopsy specimens.

In patients infected with HIV, high-grade B-cell non-Hodgkin's lymphomas (NHL), including the small noncleaved cell (SNCC) category, exhibit pleomorphic features, which makes precise definition difficult. Sixty-nine pathologic specimens with HIV-related systemic lymphomas, including 42 SNCC, 20 immunoblastic lymphomas (IBL), and 7 cases with features "intermediate" between SNCC and IBL were morphologically and immunophenotypically investigated. The host immune status was also analyzed in 57 of 69 patients. In 29 representative SNCC lymphomas, in 9 IBL cases, and an additional 3 intermediate lymphomas, both p53 protein overexpression and the association of Epstein-Barr virus (EBV) genetic information were assessed. Small noncleaved cell lymphomas included tumors exhibiting features of the 2 established subtypes (27 Burkitt's and 15 non-Burkitt's). In the seven intermediate cases, cells showed features intermediate between SNCC with plasmablastic differentiation and immunoblasts plasmacytoid. Immunoblast-like cells were also present. p53 protein overexpression and EBV association were found in a proportion of SNCC (14 of 29; 7 of 29) and intermediate (3 of 3; 2 of 3) lymphomas. Conversely, IBL cases were consistently p53 negative, but showed a high EBV association (7 of 9). All the evaluated patients with intermediate lymphomas had a considerably lower mean (76.6 per mm3 +/- 77.4 SD) and median (54 per mm3) number of CD4+ lymphocyte count than SNCC patients (mean 227.9 per mm3 +/- 186.9 SD, median 193 per mm3), thus mirroring IBL patients (mean 95.3 per mm3 +/- 82.8 SD, median 81 per mm3). All data provide evidence that lymphomas showing intermediate features constitute a distinct subgroup from either SNCC or IBL.

Biopsy↗
PubMed1996

Determination of lymphocyte immunophenotypic values for normal full-term cord blood.

Normal reference values for flow cytometric immunophenotypic lymphocyte markers for cord blood (CB) were determined using sufficient numbers of subjects for clinical laboratory use. Samples from 202 normal gestations were processed by whole blood lysis and analyzed in the following combinations: CD14/45, CD4/3, CD8/3, CD45RA/4, CD29/4, CD56/3, Cd19/3, CD19/10. Thirty-five adult laboratory volunteers were analyzed as controls. When compared to adults, CB showed increased relative percentages of naive T-helper cells, B cells, immature B cells, and CD8+3-cells and decreased T cells, cytotoxic T cells, activated T-helper cells, and large granular lymphocytes (CD56+3+). Significant differences were also found when CB samples were stratified by sex and race. These results provide clinical laboratory normal reference values for lymphocyte markers for CB, demonstrate the need for determining separate standard reference values for significantly different patient populations, provide the basis for future investigation of pathologic gestations and for clinical laboratory applications, and provide insight into early immunologic development.

Adolescent↗
PubMed1996

AIDS-related lymphoma in Brazil. Histopathology, immunophenotype, and association with Epstein-Barr virus.

The occurrence of malignant lymphoma is an increasingly important cause of morbidity and mortality in AIDS patients. The incidence of AIDS-related lymphoma in some developing countries such as Brazil is increasing as the survival of HIV infection has improved. Although there is a clear association between several types of immunodeficiency-related lymphomas and Epstein-Barr virus (EBV), the association of EBV infection in AIDS-related lymphoma in Brazil, where the incidence of AIDS is high, is unknown. Formalin-fixed, paraffin-embedded tissue from 24 cases of AIDS-related lymphoma in Brazil were analyzed for morphologic classification, immunophenotype, and EBV association using in situ hybridization studies with an EBV-EBER1 biotinylated probe. Twenty cases of AIDS-related lymphoma were classified as non-Hodgkin's lymphoma and four cases were Hodgkin's disease. Eleven non-Hodgkin's lymphomas were classified as diffuse large cell type, five cases were small non-cleaved cell, Burkitt-type, and four cases were large cell immunoblastic non-Hodgkin's lymphoma. Eighteen cases were of B-cell phenotype; one was a T-cell lymphoma, and one was classified as null. Epstein-Barr virus (EBV) was demonstrated in the majority of tumor cells of 11 of 20 (55%) of the cases non-Hodgkin's lymphomas and in 3 of 4 (75%) cases of Hodgkin's disease. AIDS-related lymphomas in Brazil are usually of large cell/immunoblastic type, but Hodgkin's disease is also seen. Both non-Hodgkin's lymphoma and Hodgkin's disease are often associated with EBV infection. The non-Hodgkin's lymphoma is predominantly of B-cell phenotype.

Adult↗
PubMed1996

The utility of flow cytometric immunophenotypic analysis in the distinction of small lymphocytic lymphoma/chronic lymphocytic leukemia from mantle cell lymphoma.

The clinical and morphologic distinction between small lymphocytic lymphoma (SLL)/ chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) is often challenging and has important prognostic and therapeutic implications. The authors investigated the usefulness of the marker CD23 in discriminating between these processes by flow cytometric immunophenotypic analysis. Consecutive samples of body fluids and hematopoietic tissue from patients with suspected B-cell lymphoproliferative disorders were studied using a panel of antibodies that included pan-B cell markers, CD5, FMC7, and CD23. Specimens from 38 patients with CD5-positive B-cell lymphoproliferative disorders consisting of a monomorphic population of small lymphoid cells were identified. Using standard flow cytometric and/or morphologic criteria, 28 patients were classified as having SLL/CLL and 10 were classified as having MCL. Neoplastic cells from all 28 patients (100%) with SLL/CLL demonstrated CD23 immunoreactivity, whereas neoplastic cells from none of the 10 patients (0%) with MCL demonstrated CD23 immunoreactivity (P < .0001). FMC7 immunoreactivity was observed in one of eight cases of SLL/CLL and in five of five cases of MCL (P = .0047). In conclusion, CD23 is a useful marker for the subclassification of CD5-positive B-cell lymphoproliferative disorders by flow cytometric analysis. FMC7 also may be a useful marker for subclassification.

Adult↗
PubMed1996

Immunophenotypic analysis of hematologic malignancy by laser scanning cytometry.

The authors tested a newly-developed computerized laser scanning cytometer (LSC) as a means of performing immunophenotypic analysis of hematologic specimens within their community hospital. Results were compared on a case-by-case basis with parallel flow cytometric and immunohistochemical data. A total of 71 specimens analyzed include 22 excised lymph nodes or other tissue biopsies, 18 peripheral bloods, 17 bone marrow aspirates, 7 body fluids, and 7 fine-needle aspiration biopsies of lymphoid tissue. The LSC proved to be a useful instrument capable of generating simultaneous two-color immunofluorescent data directly analogous to that obtained via conventional flow cytometry. However, laser scanning cytometric analysis provides advantages over flow cytometric analysis, because the LSC measures cells on a slide rather than in a fluid stream. Specifically, cells can be microscopically examined at any time--before, during, or after automated immunofluorescent analysis. In addition, specimen preparation techniques are less restricted and more cost efficient. Lastly, even extremely small and/or hypocellular specimens (such as body fluids and fine-needle aspiration biopsies) can be successfully analyzed.

Diagnosis, Computer-Assisted↗
PubMed1996

Paraffin section immunophenotyping of acute leukemias in bone marrow specimens.

The immunohistochemical evaluation of acute leukemia specimens has been limited in the past due of the inability to detect many lineage-related antigens in paraffin sections. With the improvement in immunohistochemical methods as well as the introduction of new antibodies, these limitations are now reduced. To evaluate the diagnostic utility of paraffin section immunohistochemistry in the lineage determination of acute leukemias, 77 previously immunophenotyped acute leukemias were studied with a panel of antibodies that included antibodies directed against CD3, CD20, CD34, CD43, CD68, CD79a, HLA-DR, myeloperoxidase (MPX), and terminal deoxynucleotidyl transferase (TdT). The cases included 48 acute myeloid leukemias, 18 precursor B-cell acute lymphoblastic leukemias, 6 T-cell acute lymphoblastic leukemias, and 5 mixed precursor B/myeloid leukemias. This immunohistochemical panel correctly identified the lineage of 96% of both acute myeloid leukemias and acute lymphoblastic leukemias and identified evidence of mixed lineage in 60% of mixed lineage leukemias. Antibodies directed against CD3, CD79a, MPX, and TdT were found to be the most useful, although the latter three alone were not entirely lineage specific. These findings suggest a role for paraffin section immunohistochemistry in the lineage determination of some cases of acute leukemia.

Acute Disease↗
PubMed1997

Acute myeloid leukemia with t(6;9) (p23;q34): association with myelodysplasia, basophilia, and initial CD34 negative immunophenotype.

The translocation (6;9)(p23;q34) is a rare cytogenetic aberration found in patients with acute myeloid leukemia (AML). The clinical, morphologic, and immunophenotypic findings of eight t(6;9) acute leukemias are described. The patients included six men and two women with a mean age of 38.5 years. The leukemias were classified in the French-American-British (FAB) system as AML FAB M2 in four cases and as FAB M4 in four cases. Underlying myelodysplasia was evident in six cases. Bone marrow basophilia was found at presentation in six of the seven cases studied. In two cases with basophilia, darkly stained granules were also present in many eosinophils. In one case, initial basophilia was absent, but was present at relapse, as were eosinophils containing darkly stained granules. Iron stains were available in five cases; four showed increased incorporation and three had ringed sideroblasts. All cases studied by flow cytometry (six at presentation and three at relapse) expressed CD13, CD33, and human leukocyte antigen-DR. At presentation, five cases were CD34 negative. In one case at presentation, a subset of blasts (18%) weakly expressed CD34. Three cases studied at relapse were positive for CD34. Two of seven cases studied were terminal deoxynucleotidyl transferase positive. The t(6;9)(p23;q34) was the only cytogenetic abnormality in five cases. Trisomy 8 was found in two cases, and ring 12 was present in one case. Three patients are living with refractory leukemia 6 weeks to 6 months after initial diagnosis, and three patients died of complications of allogeneic bone marrow transplantation. Only one patient is alive without evidence of disease 3 years after bone marrow transplantation. t(6;9) leukemia is an unusual type of AML that is associated with poor prognosis, early age of onset, basophilia, myelodysplasia with frequent ringed sideroblasts, and a CD34-negative initial phenotype.

Acute Disease↗
PubMed1997

Gating strategy for immunophenotyping of leukemia and lymphoma.

Clinical specimens of blood, bone marrow, lymph node, extranodal tissue, and body fluid were collected from 67 cases of hematologic neoplasms (including chronic lymphoid leukemias, T- and B-cell lymphomas, and acute lymphoblastic and myelogenous leukemias) for comparison between the right-angle light scatter (RALS)/CD45 and the forward-angle light scatter (FALS)/RALS gating combinations. One to three diagnostic markers were selected from each case, yielding 124 paired results for comparison. We found that the percentage of tumor cell isolation and the total cell count in the tumor cell gate were higher in RALS/CD45 than in FALS/RALS. When 20% was used as a cutoff point, 30 markers in FALS/RALS failed to identify the tumor population, while only 3 markers in RALS/CD45 failed to do so. The discriminative factor in the RALS/CD45 gating was mainly the CD45 intensity, whereas all cases except 3 showed low RALS. Although T-cell neoplasms showed a higher proportion of high CD45 intensity, other groups shared similar ranges of CD45 intensity, which is therefore of limited value for differential diagnosis. The RALS/CD45 combination produces higher recovery and purity for tumor cell isolation than the FALS/RALS combination and should replace the latter for routine immunophenotyping of lymphoma and leukemia.

Biomarkers, Tumor↗
PubMed1998

Combining morphology and flow cytometric immunophenotyping to evaluate bone marrow specimens for B-cell malignant neoplasms.

For this study, 188 bone marrow core biopsy specimens and aspirates analyzed morphologically and by flow cytometric immunophenotyping (FCI) in patients with a previous or new diagnosis of B-cell non-Hodgkin's lymphoma or mature B-cell leukemia were retrospectively reviewed to evaluate patterns of involvement and the usefulness of FCI. The morphologic and FCI results were categorized as follows: positive by morphologic examination and by FCI (39.9%); negative by morphologic examination and by FCI (41.5%); positive by morphologic examination and negative by FCI (11.7%); negative by morphologic examination and positive by FCI (2.6%); suggestive of malignant neoplasm by morphologic examination and positive by FCI (2.1%); and suggestive of malignant neoplasm by morphologic examination and negative by FCI (2.1%). Thus, in 81.4% of cases the morphologic and FCI findings were completely concordant. In 11.7% of cases, the morphologic examination alone detected involvement, and in 4.7% of cases, the FCI data detected involvement in a morphologically negative or "suggestive" bone marrow core. Combining these modalities is essential to evaluate bone marrow specimens for involvement by B-cell non-Hodgkin's lymphoma or B-cell leukemia.

Antibodies, Monoclonal↗
PubMed1998

Lymphoid lesions of the gastrointestinal tract: a histologic, immunophenotypic, and genotypic analysis of 49 cases.

The diagnosis of gastrointestinal (GI) lymphoid infiltrates can be challenging when based only on conventional microscopic assessment. When marked cytologic atypia is present, a diagnosis of malignant neoplasm is readily made; however, the distinction between a low-grade malignant neoplasm and a reactive process is much more difficult. If unfixed tissue is available, immunohistologic or genotypic methods that are usually aimed at defining B-lymphocytic monotypism can be applied. However, paraffin-embedded tissue has generally been deemed unsuitable for these techniques. We assessed the value of a panel of immunohistochemical stains and a seminested polymerase chain reaction (PCR) for the analysis of lymphoid infiltrates in routinely processed GI biopsy specimens from 49 archival cases, including morphologically benign, indeterminate, and overtly malignant lesions. Clinical outcome was used as the retrospective diagnostic standard; end points were death (of lymphomatous disease or otherwise) and clinical evidence of lymphoma. According to light microscopic criteria, 19 cases were classified as benign, 17 as malignant, and 13 as atypical. Immunophenotyping correctly identified 28 of 31 benign and 14 of 18 malignant lesions (7 cases had an indeterminate immunoprofile). Genotypic analysis correctly identified 12 of 18 malignant and 29 of 31 benign lesions, but spurious monoclonal bands were produced by PCR amplification of 2 of the latter 31 cases. No single technique exists for correct categorization of all paraffin-embedded specimens of GI lymphoid infiltrates. We recommend a sequential approach to the use of available diagnostic modalities.

Antigens, CD↗
PubMed1991

The morphologic and immunophenotypic assessment of the lymphocytosis accompanying Bordetella pertussis infection.

Bordetella pertussis (Bp) infection in infants and young children can be associated with a significant increase in small lymphocytes with convoluted and cleaved nuclei (SLCCN) in the peripheral blood (PB). Buffy coat smears were studied that were prepared from the PB of 11 children with documented Bp infection, whose ages ranged from one month to four years. The white blood cell count ranged from 8.4 to 72.9 X 10(9)/L, with a mean of 28.6 X 10(9)/L. In all cases, the percentage of PB lymphocytes was in the normal range; the absolute lymphocyte count ranged from 6.5 to 54.8 X 10(9)/L, with a mean of 20.3 X 10(9)/L. SLCCN represented 12-56% of the lymphocyte population. B and T lymphocytes, identified with monoclonal antibodies with the use of an immunoalkaline phosphatase method, accounted for a mean of 21% and 53%, respectively, of the total nucleated cells (TNCs) on buffy coat smears. The T-helper and T-suppressor subsets represented 38% and 16% of the TNCs, respectively, resulting in a CD4-CD8 ratio of 2.4. Most SLCCN were of the T-helper phenotype; SLCCN of the T-suppressor subset and, rarely, of the B-cell type also were identified. These observations document that the lymphocytosis associated with Bp infection in infants and young children is characterized by the presence of morphologically abnormal cells that are predominantly CD4 positive and appear to represent an expansion of an immunophenotypically normal lymphocyte population.

Antigens, CD↗
PubMed1992

Diffuse aggressive B-cell lymphomas of the gastrointestinal tract. An immunophenotypic and gene rearrangement analysis of 22 cases.

Twenty-two diffuse aggressive B-cell lymphomas of the gastrointestinal tract were studied using light microscopic examination, immunohistochemical methods, and Southern blot analysis. The results suggest that diffuse aggressive B-cell gastrointestinal tract lymphomas may be divided into two groups: large cell lymphomas and small noncleaved cell lymphomas. Large cell lymphomas often involve the stomach; commonly express the lymphocyte adhesion molecules CD44, LFA-1 (CD11a and CD18), and CD54; and may express monotypic cytoplasmic immunoglobulin in approximately one third of cases. Southern blot analysis demonstrates rearrangements of the c-myc gene that do not co-migrate with rearrangements of the immunoglobulin heavy chain gene, as detected with a JH probe in approximately one half of the cases. Small noncleaved cell lymphomas typically involve the ileocecal region. In these lesions, monotypic cytoplasmic immunoglobulin is not detected, and the CD44 and LFA-1 molecules usually are not expressed, particularly in small noncleaved cell lymphomas of the Burkitt type. The CD54 antigen is positive in fewer than one half of cases. Southern blot studies often demonstrate rearrangements of the c-myc gene that co-migrate with immunoglobulin heavy chain gene rearrangements indicative of the t(8;14) chromosomal translocation, with the c-myc region translocated into the immunoglobulin heavy chain gene joining region. Thus, immunohistochemical and genotypic results, in accordance with the site of involvement and histologic findings, suggest a different pathogenesis for large cell lymphomas and small noncleaved cell lymphomas. The findings in large cell immunoblastic lymphomas are more akin to those of the large cell group. In addition, immunophenotypic and molecular data may be helpful in improving histologic classification when the morphologic findings are equivocal.

Adult↗
PubMed2006

Immunophenotyping of chimeric cells in localized scleroderma.

OBJECTIVE: Localized scleroderma causes thickening of the skin due to excessive collagen deposition. This condition has clinical and histopathological similarities to chronic graft-vs-host disease. We wanted to identify whether chimeric cells are present in the affected tissue in localized scleroderma and to further investigate the role of chimerism by immunophenotyping the chimeric cells. We hypothesize that the presence of chimerism and immunotypic chimeric cells will lend to an understanding of the pathogenesis of localized scleroderma and possible mechanisms by which chimeric cells participate in autoimmunity. METHODS: We studied skin biopsies from 18 localized scleroderma patients and compared them with concurrent biopsies from unaffected skin in a subset of patients. Skin biopsies from morphoea and linear scleroderma patients were analysed for the presence of chimeric cells using male-female (X, Y) differences. Cell surface markers (CD4, CD8, CD19/20, CD68, S100, CD14 and CD56) were determined for cell phenotyping of chimeric cells. RESULTS: Overall, the affected tissue contained a greater number of lymphocytic inflammatory cells. In the affected tissue, 38% of the total chimeric cells were CD68+ (dendritic cell, monocyte and macrophage marker), 29% Langerin/S100+ (dendritic cell marker), 26% CD8+ (cytotoxic T-lymphocyte marker), 20% CD19/20+ (B-lymphocyte marker), 14% CD4+ (T-helper lymphocyte) and 0% CD56+ (natural killer cell marker). CONCLUSIONS: We report that not only are chimeric cells present in affected localized scleroderma lesions but they also are more likely to be dendritic cells and B lymphocytes suggesting a role in the pathogenesis of localized scleroderma.

Adolescent↗
PubMed1994

Primary cutaneous Hodgkin's disease. Unique clinical, morphologic, and immunophenotypic findings.

The authors studied five patients with primary cutaneous Hodgkin's disease (PCHD). Each patient presented with skin lesions without evidence of systemic HD. Skin lesions were papules or nodules, many of which regressed spontaneously. Lesions were distinguished from lymphomatoid papulosis (LyP) by the presence of numerous diagnostic Reed-Sternberg (RS) cells that expressed CD30 and CD15 but were negative for CD45R; LyP lesions usually are CD15-, CD45R+. Anaplastic large cell lymphoma (ALCL) was excluded by the polymorphous background of inflammatory cells in PCHD. Three patients with PCHD had a benign course without systemic disease with up to 20 years of follow-up, whereas two other patients developed mixed-cellularity HD in lymph nodes 2 months and 6 years following the onset of PCHD. This study indicates that PCHD does occur as a rare but distinct clinicopathologic entity morphologically and immunophenotypically indistinguishable from nodal HD but with an unexpectedly indolent course in some patients. Patients with PCHD should be observed for development of systemic HD, but unlike patients with LyP or ALCL, an association of PCHD with mycosis fungoides or cutaneous T-cell lymphoma has not yet been observed.

Adolescent↗
PubMed2000

Nonlymphoid intraepidermal mononuclear cell collections (pseudo-Pautrier abscesses): a morphologic and immunophenotypical characterization.

We evaluated the incidence, morphology, and immunophenotype of intraepidermal collections of mononuclear cells (ICMC) in a large number of inflammatory dermatosis and cutaneous lymphomas. ICMC appeared as small to large aggregates of cells, showing a morphology variable from monocytes to obvious dendritic cells, admixed with rare lymphocytes. ICMC were recognized in the epidermis or within hair follicle epithelium, and were either loosely or compactly arranged. ICMC were identified in 124 of 1,248 skin biopsies (9.9%) of inflammatory or lymphoid infiltrates, and were particularly frequent in spongiotic (43.4%) and in lichenoid dermatitis (10%), whereas they were rarely found in nonspecific superficial dermatitis (3.8%) and in psoriasis (4.7%). ICMC were also frequent in cutaneous T-cell lymphoma (13.3%), where they mimicked Pautrier abscesses. The ICMC forming cells showed a unique phenotype: the majority of them expressed CD1a and S-100, and lacked CD14, similar to mature Langerhans cells, but they were also strongly labeled by anti-CD11b, anti-CD36, and anti-CD68. Moreover, a subpopulation of them expressed CD83, an antigen that is usually absent on Langerhans cells. The occurrence of ICMC is a rather frequent, although hitherto poorly studied, phenomenon, occurring in several dermatosis, but particularly frequent in spongiosis-associated skin reactions. The cells within ICMC are represented by dendritic cells and dendritic cell precursors, whose phenotype indicates their derivation from circulating monocytes and differentiation into mature Langerhans cells.

Antigens, CD↗
PubMed2000

Comparative immunophenotypic study of lichen sclerosus: epidermotropic CD57+ lymphocytes are numerous--implications for pathogenesis.

To characterize the immunophenotype of inflammatory cells in lichen sclerosus (LS), we performed a comparative case control study using one- and two-color immunohistochemistry and the nitro blue tetrazolium (NBT) reaction. Study material consisted of 100 biopsies from patients with LS or from 12 control groups consisting of inflammatory, scarring, and depigmenting cutaneous disorders. In addition, fresh tissue was sampled from four vulvectomy specimens for NBT testing. The typical inflammatory infiltrate of LS contained numerous epidermotropic CD3+, CD8+, CD57+ cells, increased intraepidermal HLA-DR+ cells, and a dermal infiltrate rich in CD8+, CD57+, HLA-DR+, and CD68+ inflammatory cells. Comparing LS to the 12 control groups, epidermotropic CD57+ lymphocytes independently predicted LS (P = 0.006, logistic regression, multivariate analysis). Among the 12 control groups, only specimens of the inflammatory stage of morphea exhibited numerous dermal CD57+ lymphocytes. Two-color immunohistochemistry confirmed the CD3+/CD8+CD57+ and CD3+/ CD8+/CD57+HLA-DR+ epidermotropic and dermal lymphocytic phenotypes and the dermal macrophage CD68+HLA-DR+ phenotype. In LS, the NBT reaction revealed evidence of superoxide production associated with CD68+HLA-DR+ cells. Expansion of CD8+CD57+lymphocytes is associated with viral infections, autoimmune disease, malignancies, and transplantation and is suspected to be the result of chronic excessive antigen challenge. In these pathologic states, CD8+CD57+ lymphocytes (as terminally differentiated, antigen-specific T cells) participate in the suppression of cytolytic activity to limit tissue damage. In LS, activated macrophages and lymphocytes indicate persistent antigen-driven inflammation. LS's numerous CD8+CD57+ lymphocytes may be either the mediators or the consequence of its hallmark sclerosis.

Antigens, CD↗
PubMed1991

Infection of T but not B lymphocytes by cytomegalovirus in lymph node. An immunophenotypic study.

A 45-year-old black man presented with fever, night sweats, weight loss, and cervical lymphadenopathy. Biopsy of an enlarged node showed partial effacement of the nodal architecture by numerous cells with typical cytomegalovirus (CMV) inclusions. These were also seen by electron microscopy. CMV titers were not elevated, and he tested negative for HIV. An immunophenotypic study done on both paraffin-embedded and frozen tissue showed that the infected cells were of T-lymphocyte phenotype. These cells were remarkable for the lack of HLA-DR and IL-2R antigens, which were expressed by numerous neighboring apparently uninfected cells. The lack of HLA-DR and IL-2R expression by CMV-infected T lymphocytes may be one of the mechanism by which CMV causes immunosuppression.

Cytomegalovirus↗
PubMed1994

Malignant lymphoma of the testis, epididymis, and spermatic cord. A clinicopathologic study of 69 cases with immunophenotypic analysis.

We studied 69 cases of malignant lymphoma of the testis, epididymis, and spermatic cord, including 64 cases in which the tumor involved these sites at presentation and five cases in which lymphoma relapsed in the testis. The patients without prior lymphoma were 16 to 91 (mean, 56) years old. Fifty-two patients had diffuse large-cell lymphomas [seven large cleaved cell (two with follicular areas), 27 large noncleaved, two multilobated, six not otherwise specified (NOS), 10 immunoblastic]; six, small noncleaved cell; two, diffuse mixed small and large cell; one, diffuse small cleaved; one, follicular mixed small cleaved and large cell; and two, high grade, unclassified in the Working Formulation. Twenty-nine cases (55%) were stage I; five (9%), stage II; one (2%), stage III, and 18 (34%), stage IV. Forty patients (73%) achieved a complete remission; 23 had a relapse of tumor at 4 to 274 months (median, 13) and five were salvaged. At last follow-up, 20 (36%) patients were free of disease, six (11%) were alive with disease, and 29 (53%) had died of lymphoma. Features associated with longer disease-free actuarial survival (DFS) included stage I disease (p = 0.0001) and sclerosis (p = 0.0001). Among patients with stage I lymphoma, those with right-sided tumors (p = 0.005) or tumors with sclerosis (p = 0.0017) had longer DFS. Lymphomas with extensive sclerosis were all stage I (p = 0.0057). Four of five patients with secondary testicular lymphoma had extranodal primary sites. They ranged from 13 to 66 years (median, 35). Testicular relapses occurred 13-37 months after initial diagnosis. Three had diffuse large, noncleaved cell type; one, lymphoblastic and one, diffuse mixed small and large cell. Immunophenotyping showed B lineage in 33 cases and T lineage in one case. Most testicular lymphomas are B-lineage large-cell lymphomas, which frequently involve other extranodal sites at presentation and at relapse, and which often have an aggressive clinical course.

Adolescent↗