Summary
To improve the classification of the phenotypes of the various types of non-Hodgkin's lymphoma (NHL), 250 cases of NHL were analyzed with immunologic and enzyme cytochemical techniques. The results confirmed previous findings. Chronic lymphocytic leukemia of B-cell type (B-CLL) is characterized by a small amount of surface immunoglobulin (SIg), a predominance of C3d receptors, a large number of mouse erythrocyte receptors, and a low T-cell content. Chronic lymphocytic leukemia of T-cell type (T-CLL) has at least two subtypes: one shows a dot-like reaction product in cells stained with acid nonspecific esterase and the other does not. In prolymphocytic leukemia, there is a constantly high percentage of SIg-positive cells and a large amount of SIg on each positive cell; C3b receptors usually preponderate over C3d receptors; and there is a large number of IgG-Fc receptors. The surface marker phenotype of hairy-cell leukemia is similar to that of prolymphocytic leukemia except that hairy cells are devoid of C3 receptors and usually show a high density of IgM-Fc receptors. T-zone lymphoma usually contains both T cells and B cells. The T cells are capable of binding sheep erythrocytes only at 4 °C and can be identified cytologically as the tumor cells. In contrast, the B cells stem from residual follicles, which are often present in T-zone lymphoma at the time of the first biopsy. Three types of lymphoplasmacytic/-cytoid lymphoma (LP immunocytoma) are distinguished on the basis of morphologic features. The marker constellation of the lymphoplasmacytic subtype resembles that of centroblastic-centrocytic lymphoma. The lymphoplasmacytoid subtype and borderline cases between this subtype and B-CLL show the same markers as does B-CLL. The third subtype of LP immunocytoma, the polymorphic subtype, differs in its marker profile from all other types of NHL. The three types of lymphoma derived from germinal center cells resemble each other in the expression of nearly equal numbers of C3b and C3d receptors and a low percentage of IgG-Fc receptors. Centrocytic lymphoma is distunguished from centroblastic-centrocytic lymphoma by a large proportion of cells bearing SIg and C3 receptors and by the absence, or small proportion, of T cells and cells rosetting with mouse erythrocytes. Centroblastic lymphoma shows a marker profile that is similar to that of centroblastic-centrocytic lymphoma. The Burkitt type of lymphoblastic lymphoma shows a unique marker profile, with a high percentage of SIg-positive cells and no other markers. Analysis of lymphoblastic lymphoma of the convoluted-cell type (including cases of acute lymphoblastic leukemia with a focal acid phosphatase reaction) revealed four phenotypes. Cases with the first phenotype show C3 receptors (usually both subtypes) and a lack of sheep erythrocyte receptors. In cases with the second phenotype, the cells express both C3 receptors and sheep erythrocyte receptors. Cases with the third phenotype lack C3 receptors but contain cells rich in receptors for sheep erythrocytes that bind at 37°C. Nearly all of the cases with these three phenotypes are devoid of acid nonspecific esterase. Cases with the fourth phenotype lack C3 receptors, exhibit sheep erythrocyte receptors that bind only at 4°C, and show a focal acid nonspecific esterase reaction. Eight of nine cases of immunoblastic lymphoma showed SIg and were thus identified as B-cell derived. The ninth case was of T-cell type, as indicated by the capacity of the tumor cells to form rosettes with sleep erythrocytes.
Similar content being viewed by others
References
Burns GF, Cawley JC, Barker CR, Hayhoe GJ (1977) Absence of a receptor for fixed C3 on the hairy cells of leukemic reticuloendotheliosis. Clin Exp Immunol 29:442–446
Catovsky D, Galetto J, Okos A, Miliani E, Galton DA (1974) Cytochemical profile of B- and T-leukemic lymphocytes with special reference to acute lymphoblastic leukaemia. J Clin Pathol 27:767–771
Gerdes J, Klatt U, Stein H (1980) Xenoantiserum to human C3 receptors: Its preparation and effect on the C3b and C3d receptors of tonsil cells and the C3b receptors of erythrocytes and neutrophils. Immunology 39:75–84
Leder LD (1967) Der Blutmonozyt. Springer, Berlin Heidelberg New York
Lennert K, Mohri N (1978) Histopathology and diagnosis of non-Hodgkin's lymphomas. In: Lennert K: Malignant lymphomas other than Hodgkin's disease. Springer, Berlin Heidelberg New York, pp 111–469
Lennert K, Mohri N, Stein H, Kaiserling E (1975a) The histopathology of malignant lymphoma. Br J Haematol 31 (Suppl) 193–203
Lennert K, Stein H, Kaiserling E (1975b) Cytological and functional criteria for the classification of malignant lymphomata. Br J Cancer 31 (Suppl. II) 29–43
Lukes RJ, Collins RD (1975) New approaches to the classification of the lymphomata. Br J Cancer 31 (Suppl. II) 1–28
Rieber EP, Linke RP, Hadam M, Saal JG, Riethmüller G, v. Heyden HW, Waller HD, Schwarz H (1977) Hairy-cell leukemia: Simultaneous demonstration of autochthonus surface-Ig and monocytic functions of hairy cells. In: Immunological diagnosis of leukemias and lymphomas. Haematol Bloodtransfus 20:157–161
Rodt H, Thierfelder S, Thiel E, Götze D, Netzel B, Huhn D, Eulitz M (1975) Identification and quantitation of human T-cell antigen by antisera purified from antibodies crossreacting with hemopoietic progenitors and other blood cells. Immunogenetics 2:411–430
Stein H (1976) Klassifikation der malignen Non-Hodgkin-Lymphome aufgrund gemeinsamer morphologischer und immunologischer Merkmale zwischen normalen und neoplastischen lymphatischen Zellen. Immun Infekt 4:52–69, 95–109
Stoin H (1978) The immunologic and immunochemical basis for the Kiel classification. In: Lennert K, Malignant lymphomas other than Hodgkin's disease. Springer, Berlin Heidelberg New York, pp 529–657
Stein H, Lennert K, Parwaresch MR (1972) Malignant lymphomas of B-cell type. Lancet II:855–857
Stein H, Papadimitriou CS, Bouman H, Lennert K, Fuchs J (1978) Demonstration of immunoglobulin production by tumor cells in non-Hodgkin's and Hodgkin's malignant lymphomas and its significance for their classification. In: Mathé G, Seligman M, Tubiana M (eds) Lymphoid neoplasias, I. Recent Results Cancer Res, 64:158–175
Stein H, Tolksdorf G (1979) Die immunologische Basis der Kiel-Klassifikation der malignen Non-Hodgkin-Lymphome. In: Stacher A, Höcker P (Hrsg) Lymphknotentumoren. Urban und Schwarzenberg, München Wien Baltimore, S 108–115
Stein H, Tolksdorf G, Burkert M, Lennert K (1979) Cytologic classification of non-Hodgkin's lymphomas based on morphology, cytochemistry and immunology. In: Crowther DG (ed) Leukemia and Non-Hodgkin Lymphoma. Advances in medical oncology, research, and education, Vol. 7. Pergamon Press, Oxford New York, pp 141–152
Stein H, Tolksdorf G, Lennert K (1980) T-cell lymphomas. A cell origin-related classification on the basis of cytologic, immunologic, and enzyme-cytochemical criteria. Pathol Res Pract (in press)
Tolksdorf G, Stein H (1979) Acid alpha-naphthyl acetate esterase in hairy-cell leukemia cells and other cells of the hematopoietic system. Blut 39:165–167
Tolksdorf G, Stein H, Lennert K (1980) Morphological and immunological definition of a malignant lymphoma derived from germinal center cells with cleaved nuclei (centrocytes). Br J Cancer 41:168–182
Author information
Authors and Affiliations
Additional information
Supported by the Deutsche Forschungsgemeinschaft, SFB 111, project no. CL 1
Rights and permissions
About this article
Cite this article
Stein, H., Staudinger, M., Tolksdorf, G. et al. Immunologic markers in the differential diagnosis of non-Hodgkin's lymphomas. J Cancer Res Clin Oncol 101, 29–42 (1981). https://doi.org/10.1007/BF00405061
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00405061