We report an autopsy case of malignant lymphoma of the cranial vault. The patient was an 85-year-old woman who exhibited a painless subcutaneous scalp lump associated with no neurological abnormalities. CT scan and magnetic resonance imaging of the head showed an extra-intra cranial isodensity lesion of the cranial vault. Autopsy revealed that the tumor was composed of medium-sized cells which were immunoreactive with CD45, CD20, CD79a, and CD10, and a diagnosis of peripheral B cell lymphoma, Burkitt-like, was made. Non-Hodgkin lymphoma originating from the cranial vault is extremely rare; a search of the English literature revealed only 16 previously reported cases. Herein, we review this singular calvarial lymphoma.

By using four distinct monoclonal antibodies to CEA, the molecular profile of which was clarified in our accompanying companion paper, immunohistochemical distribution of the antigenic determinants on both cancerous and noncancerous tissues as well as fetal tissues was studied with the use of the immunoperoxidase method. All of the monoclonal antibodies recognize different antigenic determinants on the tissue section. None of the antibodies stained granulocytes in the peripheral blood or in the normal liver tissues tested. Three of our monoclonal antibodies stained columnar epithelial cells in morphologically normal colonic mucosa; however, monoclonal antibody YK024 did not stain them. This antibody was also found to be unreactive with intestinal metaplasia lesions of the stomach, but reacted with a 16-wk-old fetal stomach as well as with cancerous parts of the colon and of the stomach. Moreover, it was found that this monoclonal antibody mainly reacted with moderately or poorly differentiated adenocarcinoma lesions of the colon and the stomach. Periodic acid treatment in this study, together with trypsin treatment on the antigen as described in our accompanying companion paper, may suggest that this antibody recognizes the carbohydrate antigenic determinant in nature.

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The serologic and molecular characterization of four monoclonal antibodies to human gastric cancer cells and to CEA were described and the immunohistologic patterns of reactions with freshly obtained gastrointestinal tissues were examined. Monoclonal antibody YK004, which was secreted by the hybridoma constructed with the gastric carcinoma cell line KATO III, reacted with an antigenic determinant preferentially expressed on human gastric and colonic carcinoma cells, but it failed to bind any nonmalignant tissues tested except the stomach. Although this antibody reacted with fetal digestive tract tissues, it failed to immunoprecipitate CEA. Monoclonal antibodies YK013 and YK024 prepared in the same manner by immunizing with the gastric carcinoma cell line KATO III reacted with antigenic determinants on CEA, but not on NCA or NCA2. The antigenic profiles recognized by these two antibodies were found to be identical by sequential immunoprecipitation experiments. However, the antigenic determinant recognized by antibody YK013 may be different from that recognized by antibody YK024, since the immunohistologic reactivity patterns in carcinoma tissue sections were clearly different. Monoclonal antibody AS001, which was secreted by the hybridomas constructed with purified CEA as immunogen, immunoprecipitated CEA molecule with a single antigenic structure of 200 Kd, which was different from the antigenic profile detected by two other monoclonal antibodies, YK013 and YK024. The unique distribution of the antigenic determinants recognized by our monoclonal antibodies on cancerous tissues suggests that antibodies might be able to detect the unique determinants of the circulating CEA molecule or CEA-related molecules in the serum of cancer patients.

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