Cell surface phenotype in lymphoproliferative disease
Aisenberg, A.C.; Wilkes, B.M.; Long, J.C.; Harris, N.L.
American Journal of Medicine 68(2): 206-213
1980
ISSN/ISBN: 0002-9343 PMID: 6965562 Document Number: 162298
The surface phenotype of peripheral blood lymphocytes from 45 patients with chronic lymphocytic leukemia (CLL) and of lymphoid tissue from 100 patients with other lymphoproliferative disease was determined. Surface immunoglobulin (SIg) and complement receptor were employed as B [bone marrow-derived] cell markers; reactivity with sheep erythrocytes (E rosettes) and antithymocyte globulin was used to identify T [thymus-derived] cells. Of these markers, only SIg and E rosettes reliably identified cells of the respective lineages. SIg identification with fluorescent antisera had the added advantages of allowing the discrimination between different B cell subsets on the basis of staining intensity, and establishing the clonal character of a proliferation by the presence of predominant L and H chains. A uniform surface phenotype was observed in CLL, characterized by faintly staining SIgM with or without SIgD (1/6 of the patients were SIgG-positive), the presence of complement receptor and the absence of reactivity with sheep erythrocytes or antithymocyte globulin. Nodular (poorly differentiated lymphocytic) lymphoma was also uniformly of B cell lineage, but staining for SIgM was brighter (1/3 of these tumors were SIgG-bearing). Although cell suspensions of these neoplasms were uniformly E rosette-negative, the presence of complement receptor and reactivity with antithymocyte globulin were variable. Diffuse poorly differentiated lymphocytic lymphoma and 2 cases of Burkitt's lymphoma were very bright SIgM-positive, E rosette-negative neoplasms. Of the diffuse histiocytic lymphomas, 60% exhibited either SIgM- or SIgG-positive B cells which stained brightly, but the other 40% comprised tumors of T cell lineage or of a phenotype which could not be conclusively identified. The mixed histiocytic and lymphocytic lymphomas, which occupy an awkward place in pathology, could not be defined by surface markers. Surface makers should not replace routine pathologic criteria as the basis of classifying lymphoma, but cell phenotype is proving to be an increasingly useful added dimension for understanding and classifying this complex group of diseases.