Donald R. Howard

Carcinoma‐associated cytostructural antigenic alterations: Detection by lectin binding

Tumor cell membrane glycoproteins may be involved in the induction of tumor immunity or in the escape of tumors from immunologic defense mechanisms. Previous investigations have suggested a role for blood group antigens and their precursors, in the generation of the immune response to neoplasia. In this study, 44 benign and malignant breast lesions were examined for the presence of a carbohydrate precursor antigen (T‐antigen) of the human blood group system MN. T‐antigen was demonstrated using an immunohistochemical technique to detect tissue binding of a plant lectin (PNA) with specificity for T‐antigen. Of the 22 benign breast lesions examined, 19 showed T‐antigen present along the luminal cytoplasmic membrane and occasionally on intraluminal secretions. T‐antigen, as demonstrated by lectin binding, was confined to this region in all benign lesions except one, which also showed cytoplasmic positivity. Malignant breast lesions showed a pattern of T‐antigen expression markedly different from that of benign breast tissues. Of 22 breast carcinomas, 17 showed diffuse cytoplasmic T‐antigen. Five carcinomas showed no evidence of T‐antigen by this technique. These malignancies tended to be the most poorly differentiated when judged by histologic criteria. A possible role for T‐antigen in the modulation of the immune response to breast carcinoma is suggested.

Warthin's tumor: A functional immunologic study of the lymphoid cell component

The origin and nature of the lymphoid cell component of Warthins tumor are controversial. The present report describes the application of immunologic functional testing to the study of Warthins tumor lymphocytes. Numbers of B and T cells are comparable to those of other lymph nodes. A vigorous stimulatory response to phytohemagglutinin reflects the predominance of functional T cells. These findings, in conjunction with morphologic observations, support the concept that the lymphoid component of Warthins tumor is derived from a pre-existing lymph node.

Differentiation of chronic lymphocytic leukemia from reactive lymphocytosis by the mouse red cell rosette assay

The differential diagnosis of chronic lymphocytic leukemia (CLL) from other neoplastic and nonneoplastic lymphocytoses may be difficult, even when optimal clinical and laboratory data are available. The mouse red cell (M) rosette assay has been valuable in distinguishing normal and lymphomatous lymphocytes from those of CLL. Not yet tested is the ability of this test to separate reactive (benign) lymphocytes from morphologically similar but neoplastic cells of CLL. In the present study, lymphocytes of 58 subjects with CLL, reactive lymphocytosis, and healthy controls were evaluated for M rosette formation, in addition to the usual B and T cell markers. Lymphocytes from patients with CLL showed a marked increase in the ability to form M rosettes in comparison to those from normal controls and patients with reactive lymphocytosis. The formation of M rosettes was a more reliable marker for CLL than surface membrane immunoglobulin.

T‐Antigen does not induce cell mediated immunity in patients with breast cancer

A total of 80 subjects with benign and malignant breast disease and healthy controls were studied for reactivity to T‐antigen, MN‐antigens and phytohemagglutinin (PHA) using the lymphocyte blastogenesis assay. No differences were detected between controls and patients with benign or malignant breast disease in reactivity to T‐ and MN‐antigens. Moreover, there was no differential response to T‐ and MN‐antigens among patients with breast cancer. PHA reactivity, although similar between groups as a whole, was diminished in patients with advanced carcinoma. These findings indicate that T‐antigen fails to induce cell mediated immunity in patients with breast cancer.

Hodgkin's disease: pathology and pathogenesis.

The pathogenesis of Hodgkins disease has been the subject of intensive investigation for nearly a century. Numerous lines of inquiry have been pursued and the resulting quantity of literature on the subject attests to the enigmatic nature of the disease. Periodically, it becomes prudent to review progress in the study of a disease such as this, in light of recent methodologic and conceptual advances. By so doing, a more integrated view of the disease process may emerge, thereby guiding future research endeavors. The present report is undertaken to explore, in depth, recent advances in the study of the pathology and pathogenesis of Hodgkins disease. Contemporary classifications, clinicopathologic and epidemiologic studies, cellular and humoral derangements, and the controversial nature of the Reed-Sternberg cell are considered.

Hodgkin's disease: contemporary classification and correlates.

The current histologic classification of Hodgkins disease into lymphocyte predominance, nodular sclerosis, mixed cellularity, and lymphocyte depletion forms is practical, reproducible by pathologists, and correlates with extent and course of disease. Such a classification, however, is only a step toward complete understanding of this often enigmatic disease.