K. Sesterhenn

Nasopharyngeal and adjacent neoplasms: a clinico-pathologic and immunologic study.

SummaryThirteen cases of nasopharyngeal carcinoma (NPC) and 16 cases of non-NPC tumors in the nasopharynx or in adjacent locations were investigated clinically, immunologically, and pathologically. All tumors were classified according to the TNM classification, and the stage and course of the disease was correlated with the histological tumor type, the T- and B-cell distribution in tumor tissue and in the peripheral blood, as well as with antibody titers against Epstein-Barr virus (EBV). The results showed a positive correlation of decreased T- and B-cells in tumor tissue and of decreased T-cells in the peripheral blood with the extend of the tumor in both NPC and non-NPC cases, with some exceptions of lymphocyte rich neoplasms (lymphoepithelial carcinoma and malignant lymphoma). Antibodies against EBV (early antigen and capsid antigen) became progressively elevated with increasing tumor stage in NPC-cases but not in non-NPC cases. The latter, however, was observed only in two histological types of NPCs: anaplastic carcinoma and lymphoepithelial carcinoma; titers in the remaining tumor types stayed insignificant.ZusammenfassungDreizehn Fälle nasopharyngealer Carcinome (NPC) und 16 Fälle nicht-nasopharyngealer Carcinome in der gleichen oder in benachbarter Region wurden klinisch, pathologisch und immunologisch untersucht. Alle Tumoren wurden entsprechend der TNM-Klassifikation eingruppiert, und das Ausbreitungsstadium und der Verlauf der Erkrankung wurden korreliert mit dem histologischen Tumortyp, der T- und B-Lymphozytenverteilung im Tumorgewebe und im peripheren Blut sowie mit den Antikörpertitern gegen Epstein-Barr-Virus (EBV). Die Ergebnisse zeigten deutliche Beziehungen zwischen Abnahme prozentualer T- und B-Zellen im Tumorgewebe und T-Zellen im peripheren Blut und dem Ausbreitungsstadium des Tumors bei NPC als auch bei nicht-NPC-Fällen; eine teilweise Ausnahme bildeten lediglich lymphozytenreiche Neoplasien (lymphoepitheliale Carcinome und maligne Lymphome). Antikörper gegen EBV (Frühantigen und Kapselantigen) zeigten eine mit dem Tumorstadium zunehmende Erhöhung bei NPC-Fällen, jedoch nicht bei nicht-NPC-Fällen. Auch bei NPC-Fällen wurde dieses Phänomen nur bei zwei histologischen Typen beobachtet: Bei anaplastischen Carcinomen und bei lymphoepithelialen Carcinomen; die Titer der übrigen Tumortypen blieben unauffällig. Die Bedeutung dieser Befunde wird diskutiert.

Percent Distribution of T- and B-Cells in Tonsils of Children, Juveniles and Adults

SummaryThe percent distribution of T- and B-lymphocytes in tonsilar tissue of 122 patients from 2–68 years and both sexes was investigated.T-cells were determined by the E-rosetting technique and B-cells by immuno-fluorescence. We found 50.3% B-cells and 30.6% T-cells in tonsilar tissue.There was a significant decrease of IgM-receptor carrying cells with increasing age and with a converse behavior of the sum of IgA-, IgD-, IgE-receptor B-cells. In tonsils with acute inflammation and with hyperplasia IgM cells were also increased significantly when compared to cell counts in chronic tonsillitis.The results are discussed and compared to data from the literature.

[The distribution of B-lymphocytes in lymphoepithelial tissues as well as in tumors of the neck-, nose-, and throat region derived from lymphoreticular and lymphoepithelial tissues (author's transl)].

B-Lymphocytes carrying IgG-, IgM,- and IgA-surface receptors were estimated by fluorescence microscopy in the palatine tonsil of 50 patients aged 3 to 18 years as well as in 44 patients with various types of malignant lymphoms and lymphoepithelial carcinomas. Hyperplastic tonsillartissue contains large numbers of B-cells with a marked variability in concentration (4-30% IgG-cells, medium 12,9%;6-36 IgM-cells, medium 23.4%;3-38% IgA cells, medium 20.8%). There appears to exist an age-dependent increase in IgM-cells and an increase in IgG-and IgA-cells in patients with numerous recurrent infections of the upper respiratory tract. Malignant lymphomas can be grouped into three main categories: Such with a predominance of one B-cell line (above 75-80% of one immunological cell type); these include primarily malignant lymphomas of the well differentiated lymphocytic type (IgM and IgA receptors). Secondly, such with a significant decrease in B-cells (below 10%) which include primarily malignant lymphomas of the poorly differentiated lymphocytic type. Thirdly, such with an increased B-cell content but with more than one cell line participating in cell proliferation. The latter ones comprise certain cases of Hodkins lymphomas. Lymphoepithial carcinomas are charactersized by a significant decrease in total B-cell content, except for IgE- and IgD-cells which were not investigated. The results show that the immunologic classification of malignant lymphomas correlates only to a certain degree with the morphologic classification; i.e. the same morphologic type of tumor may possess different immunologic characteristics. Since the immunologic characteristics may reflect a certain functional potential of these tumors as well as probably a certain kind of immunologic incompetence prior to tumor development, it is suggested, that future morphologic investigations of malignant lymphomas and lymphoepithelial carcinomas are combined with immunologic classifications.SummaryB-Lymphocytes carrying IgG-, IgM-, and IgA-surface receptors were estimated by fluorescence microscopy in the palatine tonsil of 50 patients aged 3 to 18 years as well as in 44 patients with various types of malignant lymphoms and lymphoepithelial carcinomas. Hyperplastic tonsillar tissue contains large numbers of B-cells with a marked variability in concentration (4–30% IgG-cells, medium 12,9%; 6–36 IgM-cells, medium 23.4%; 3–38% IgA cells, medium 20.8%).There appears to exist an age-dependent increase in IgM-cells and an increase in IgG- and IgA-cells in patients with numerous recurrent infections of the upper respiratory tract.Malignant lymphomas can be grouped into three main categories: Such with a predominance of one B-cell line (above 75–80% of one immunological cell type); these include primarily malignant lymphomas of the well differentiated lymphocytic type (IgM and IgA receptors).Secondly, such with a significant decrease in B-cells (below 10%) which include primarily malignant lymphomas of the poorly differentiated lymphocytic type.Thirdly, such with an increased B-cell content but with more than one cell line participating in cell proliferation. The latter ones comprise certain cases of Hodkins lymphomas.Lymphoepithelial carcinomas are characterisized by a significant decrease in total B-cell content, exept for IgE- and IgD-cells which were not investigated.The results show that the immunologic classification of malignant lymphomas correlates only to a certain degree with the morphologic classification; i. e. the same morphologic type of tumor may possess different immunologic characteristics.Since the immunologic characteristics may reflect a certain functional potential of these tumors as well as probably a certain kind of immunologic incompetence prior to tumor development, it is suggested, that future morphologic investigations of malignant lymphomas and lymphoepithelial carcinomas are combined with immunologic classifications.ZusammenfassungB-Lymphocyten mit IgG-, IgM- und IgA-Oberflächenreceptoren wurden in Tonsillen von 50 Patienten im Alter zwischen 3 und 18 Jahren sowie bei 44 Patienten mit verschiedenen Typen maligner Lymphome und mit lymphoepithelialen Carcinomen untersucht.Hyperplastisches Tonsillengewebe enthält eine große Zahl von B-Zellen mit einer bemerkenswerten Streubreite der verschiedenen Zelltypen (4–30% IgG-Zellen, Mittelwert 12,9%; 6–36% IgM-Zellen, Mittelwert 23,4%; 3–38% IgA-Zellen, Mittelwert 20,8%).Dabei scheint eine altersabhängige Zunahme bei den IgM-Zellen vorzuliegen sowie eine Zunahme an IgG- und IgA-Zellen bei Patienten mit zahlreichen rezidivierenden Infekten im Bereich des oberen Respirationstraktes.Maligne Lymphome können in drei Hauptkategorien unterteilt werden: 1.Solche mit Vorherrschen einer B-Zellart (über 75–80% eines immunologischen Zelltyps); hierbei sind vor allem maligne Lymphome des gut differenzierten lymphocytären Typs (IgM- und IgA-Receptoren) betroffen.2.Solche mit einer signifikanten Abnahme an B-Zellen (unter 10%), wobei vor allem maligne Lymphome des schlecht differenzierten lymphocytären Typs betroffen sind.3.Solche mit einem gesteigerten B-Zellgehalt, wobei mehr als nur eine Zell-Linie an dem proliferativen Geschehen teilnimmt. Letztere Kategorie schließt auch gewisse Fälle von Hodkin-Lymphomen mit ein. Lymphoepitheliale Carcinome lassen sich durch eine signifikante Abnahme des gesamten B-Zellgehaltes charakterisieren (abgesehen von IgE- und IgD-Zellen, welche nicht mituntersucht wurden).Die Ergebnisse zeigen, daß die immunologische Klassifikation maligner Lymphome nur bis zu einer gewissen Stufe mit der morphologischen Klassifikation korreliert; der morphologisch gleiche Tumortyp kann unterschiedliche immunologische Charakteristica aufweisen.Nachdem die immunologischen Charakteristica ein gewisses funktionelles Potential und auch wahrscheinlich eine bestimmte Art von Störung des Immunsystems, welches der Tumorentstehung vorausgeht, wiederspiegeln, wurde vorgeschlagen, daß künftig morphologische Untersuchungen maligner Lymphome und lymphoepithelialer Carcinome mit immunologischer Klassifikation kombiniert werden sollten.

Non-Hodgkin Lymphomas: Cell Populations and Functional Behavior*

Subject of this presentation is to discuss the prognostic significance of immunocytological, tissue culture, and serological studies in patients with malignant lymphomas.

Zur zellulären Immunreaktivität von Tumorpatienten: T-Zellen im peripheren Blut

SummaryIn a total of 95 patients with malignant tumors (mainly squamous cell carcinoma) of head and neck T-lymphocytes in the peripheral blood were determined by the spontaneous rosetting phenomenon of Bach. Patients were devided into following groups:1.Controlgroup.2.Untreated tumor patients.3.Patients without any tumorous remnants treated by4.combined surgical and radiologieal meansa)combined surgical and radiological means,b)only radiological methods, or byc)only surgical procedures.d)Patients with advanced tumor under current cytostatic therapy. T-lymphocytes of untreated tumor patients seemed to be reduced but there was no significant difference to the control group.The T-cell counts of cured patients which were treated by radiation were significantly diminished. In contrast T-cells in only surgically treated patients were not reduced.In patients with advanced tumors under current cytostatic treatment peripheral T-cells were also significantly diminished when compared with the control group and with only surgically cured patients.The results are discussed and compared to similar publications on the immune reactivity of tumor patients.

Klassifikation maligner Lymphome des Halsbereiches: Kombinierte morphologische, immunzytologische, serologische und Zellkultur-Untersuchungen

Summary81 untreated malignant lymphomas of the neck were classified morphologically according to the German Kiel classification and to the American classification of Rappaport and Berard and these tumors were typed immunologically as to their T- or B-cell nature. Cells from 16 of these patients were subsequently grown in tissue culture for periods up to seven months. Tissue culture cells were monitored as to spontaneous variations in the morphologic cell type and to the expression of T- or B-cell surface determinants. In addition in 10 patients sera were tested for anti-Epstein-Barr virus (EBV) antibodies. The results of these investigations were correlated with the course of the individual neoplastic disease. Significantly elevated titers against EBV antigens were detected primarily in 8 of 10 patients, mainly in lymphocytic lymphomas respective lymphoplasmacytoid immunocytomas. All such neoplasms belonged immunologically to B-cell lymphomas and were readily grown in tissue culture. The morphological cell type and the expression of B-cell determinants showed some variation during the culture period.In contrast, lymphomas of EBV-negative patients or patients with low EBV-titers grew poorly in tissue culture and remained morphologically more stabile. Immunocytologically they belonged to tumors with B- and T-cell deficiency and were classified primarily as histiolytic lymphomas and as Hodgkins lymphomas.The clinical course in slow proliferating tumors seemed to be disadvantageous.

Untersuchungen über das Verteilungsmuster immunkompetenter Zellen mit Antikörperreceptoren (B-Zellen) in Tonsillen von Kindern und Jugendlichen

SummaryViable lymphocytes were isolated from tonsils of about 50 children and young adults. These lymphocytes were incubated with fluoresceinisothiocyanate labeled antibodies against human IgG, IgM and IgA and examined for membranefluorescence.The obtained pattern of the distribution of cells is visualized in diagrams. The results were analysed in connection with clinical and histological findings and with age groups. We found a wide spreading of different B-cell types. This was most significant in IgM cells when different age groups were compared. Repeated infections appear to produce an increase of IgG and IgA cells.Polyvalent immunisations including oral polio vaccination are followed by a slight increase of IgM cells.In histological prooved acute and chronical infected tonsils IgA cells are more frequent than in tonsils with simple hyperplasia.