No abstract

Twenty-nine cases of non-Hodgkin's lymphoma of Waldeyer's ring (W-NHL) and nasal cavity or paranasal sinus (N-NHL) were studied for tumor-surface marker phenotype and histopathologic correlation with clinical features. Immunostaining procedures on tissue sections by using xenoantisera and monoclonal antibodies to human B- and T-cells enabled the authors to demonstrate precise surface marker phenotypes of tumor cells and, moreover, the histologic localization of normal or neoplastic B- and T-cells in preserving the original structure of lymphoid organs or tumor tissues. In 22 cases of W-NHL, 19 (86%) had B-cell markers and 3 (14%) had T-cell markers, whereas 6 of 7 cases (86%) of N-NHL had T-cell markers. Tumor cells in T-cell lymphomas in W-NHL and N-NHL reacted with antibodies to peripheral T-cells except one case of W-NHL. Rappaport "histiocytic" subtype was heterogeneous with respect to both surface marker characteristics and morphologic features, i.e., seven had B-cell markers and four had T-cell markers, and they were all subdivided into "large cell" or "large cell, immunoblastic" in Working Formulation and "large cell" or "pleomorphic" in Lymphoma Study Group classification. The actuarial survival curve for all T-cell lymphoma patients was characterized by a rapid initial decline and a subsequent plateau, which contained two of the long survivors. In contrast, the B-cell lymphoma group had a more graded decline. The median and actuarial survivals of the T-cell lymphoma group were far inferior to those for the lymphoma group that expressed B-cell markers.

HlROYOSHl HIRATSUKA, DDS,' MASAKATSU IMAMURA, MD. PHD,t YOSHlFUMl ISHII, MD, PHD,t GEN-IKU KOHAMA, DDS, PHD,' AND KOKlCHl KIKUCHI, MD, PHDtCancer tissues from 30 patients with squamous cell carcinoma of the oral cavity were examined immunohistopathologically as to the responsiveness of the host against its own cancer cells in both biopsy and surgically resected specimens from the same patients. Subpopulations of the infiltrating lymphocytes in cancer tissues were identified on paraffin-embedded serial sections by a modified indirect immunoperoxidase technique (PAB method) in which it was combined with peroxidase-antiperoxidase (PAP) complex and avidin-biotin system with rabbit anti-human B-cell, peripheral T-cell sera. Macrophages were also identified by nonspecific acid esterase staining. T-cells were predominant over B-cells in 26 of 30 tissues in biopsy specimens and 23 of 30 in surgically resected specimens with bleomycin treatment. T-cell infiltration in the peripheral region of the tumor was more prominent than that in the stroma among the cancer nests. T-cells surrounded the cancer nests, occasionally accumulated around the cancer cells, infiltrated a t the marginal part of the cancer nests, and frequently produced perivascular massive accumulations. B-cells and macrophages, on the other hand, were almost absent or negligible around cancer tissues. The grade of T-cell infiltration, especially in biopsied specimens, was correlated well to the size of the tumor, and also more marked significantly in patients without cervical lymph node metastasis than in those with lymph node metastasis. Furthermore, there was a significant correlation between the grade of T-cell infiltration at the peripheral region of the invading cancer mass in initial biopsy specimens and the clinical tumor regression rates with bleomycin treatment, but it did not correlate to the surgically resected specimens. These facts suggest that T-cells might inhibit the development and spreading of the cancer cells, and that the T-cell infiltration correlates with the clinical course or prognosis of the oral cancer patients.

Endoscopic ultrasonography (EUS) and magnetic resonance imaging (MRI) are becoming popular methods for examining tumorous lesions along the upper gastrointestinal tract. Though duplication cysts are uncommon, EUS findings from gastric duplication cysts have accumulated and proven very useful for preoperative diagnosis. There have been few reports, however, concerning MRI findings from these cysts. We report herein the case of a 25-year-old man with a gastric duplication cyst. EUS demonstrated a cystic mass adjacent to the fourth layer of the stomach wall. MRI revealed a cyst containing low signal-intensity fluid and high signal-intensity fluid separated by levels. In addition to the characteristic findings from preoperative examinations, the unique histological findings from the cyst are also described.

Six cases were described in which an initial clinical diagnosis of “rhinitis gangrenosa progressiva” or lethal midline granuloma was made. The histological examinations of their surgical and autopsy specimens proved that their nasologic diseases could all be identified as malignant lymphoma arising from the nasal cavity, showing the general histologic characteristics reported for T‐cell lymphomata derived from peripheral T‐cells. This histologic observation was then confirmed by immunofluorescence studies using various antisera directed toward either human T‐ or B‐cell‐surface antigens. These studies clearly demonstrated that their malignant cells bore human Ly‐l‐like antigen but lacked human TL‐like and la‐like antigens as well as surface‐bound immunoglobulins, indicating their peripheral T‐cell origin. These data may suggest that so‐called “rhinitis gangrenosa progressiva” or lethal midline granuloma contains at least two distinct disease categories, one of which is Wegener's granulomatosis, and the other of which is nasal T‐cell lymphoma as described herein.