Primary gastrointestinal lymphomas:A classification of 66 cases

Abstract

Using routine histology, resin embedded sections and immunohistochemical techniques on formalin-fixed, paraffin processed tissue, 66 cases of primary gastrointestinal lymphoma have been classified. This study necessitated the development of reliable criteria to separate lymphomas of true histiocytic origin from those of lymphocytic origin. Among the morphologic properties of malignant histiocytes were complex pleomorphic nuclei, abundant well delineated cytoplasm and phagocytosis. These cells were shown to contain all major immunoglobulin chains, C3, lysozyme and in some cases alpha 1 antitrypsin. Malignant lymphomas derived from histiocytes could be divided into two groups: malignant histiocytosis of the intestine (MHI), a recently described diffuse pleomorphic lymphoma associated with villous atrophy of the small intestine, and histiocytic lymphoma (HL) which forms solid tumor masses in a similar manner to lymphocyte derived tumors. Immunohistochemical studies of lymphocyte derived tumors were negative apart from one case with plasmacytoid differentiation. Of the 66 cases, 50% were of histiocytic origin (33% MHI, 17% HL) and 41% of lymphocyte origin, there was one case of Hodgkin's disease and five cases were unclassified. The role of the histiocyte in gastrointestinal mucosa deserves further study.

Immunochemical demonstration of J chain: a marker of B-cell malignancy.

“…Likewise, it would appear that the immunoglobulin in Reed-Sternberg cells is not synthesised by them. Polytypic staining of malignant lymphomas is being reported with increasing frequency (Isaacson and Wright, 1978a;Taylor, 1978;Taylor et al, 1978;Isaacson et al, 1979), and it is important to be able to separate those cells synthesising immunoglobulin from cells taking it up from the environment. While staining for J chain achieves this, the exact mechanism whereby immunoglobulin enters the tumour cells is still uncertain.…”

“…Polytypic immunoglobulin staining is characteristic of the tumour cells in malignant histiocytosis of the intestine and of the Reed-Sternberg cell of Hodgkin's disease (Taylor, 1974;Curran and Jones, 1978). In the former, the malignant cells have been clearly shown to be derived from histiocytes (Isaacson and Wright, 1978a and b;Isaacson et al, 1979), and their polytypic immunoglobulin content Received for publication 2 January 1979 could be explained by phagocytosis, but the derivation of the Reed-Sternberg cell remains uncertain. A histiocytic origin is favoured by some workers (Kaplan and Gartner, 1977;Long et al, 1977;Kadin et al, 1978) but others have produced evidence from ultrastructural studies that Reed-Sternberg cells synthesise immunoglobulin (Diebold et al, 1977;Bernuau et al, 1978).…”

Combined surgery and chemotherapy for the treatment of primary gastrointestinal intermediate- or high-grade non-Hodgkin's lymphomas

“…The gastrointestinal tract is the site most frequently affected at diagnosis accounting for about 4-18% of all extranodal forms of NHLs (Freeman et al, 1972;Reddy et al, 1980;Ho et al, 1984;Lewin et al, 1978;Isaacson et al, 1979;Herrmann et al, 1980;Hande et al, 1978;Strauss et al, 1983;Gospodarowicz et al, 1983;Siegert et al, 1985;Carnevali et al, 1987). While several studies have emphasised the effectiveness of the complete surgical resection of localised lesions (Siegert et al, 1985;Fleming et al, 1982;Maor et al, 1984;Paulson et al, 1983), the majority of authors consider this therapeutic approach as non-curative.…”

Monoclonal immunoglobulin light chain in urine of patients with B lymphocytic disease: Its source and use as a diagnostic aid

“…The NHL patients were classified by using the system described by Gerard-Marchant et al (1974) with staging according to the Ann Arbor Conference (Carbone, 1971) (Table II (Isaacson et al, 1979), 2 (RR and BW) were immunologically reactive without tumour involvement and one (JU) exhibited features of angioimmunoblastic lymphadenopathy (AILD) (Lukes & Tindle, 1975 and did not exceed 20%.…”