A study of malignant lymphomas using light and ultramicroscopic, cytochemical and immunologic technics. Correlation with clinical features

Light microscopic and ultrastructural morphology, enzyme cytochemistry, cell surface and functional markers were used to further characterize the nature of the proliferating cells in 50 patients with malignant lymphoma. Appropriate clinical information was also included. In 40 patients (80 per cent), a predominant population of monoclonal B cells was found. Within this group, one cell type was recognized morphologically by its characteristic faint surface membrane immunofluorescence. This type appeared identical to the cells in chronic lymphocytic leukemia. A second cell type, recognized by its bright surface immunoglobulin, contained two subtypes delineated by light microscopic and ultrastructural features. A third cell type, characterized by its ability to phagocytize, positive staining for nonspecific esterases and dense cytoplasmic granules, was recognized in one leukemic patient. A fourth cell type (two patients) formed sheep red blood cells (SRBC) rosettes at 4 °C and 37 °C, indicating a T cell lineage. A fifth cell type, defined by the absence of any cell marker, was identified in two other leukemic patients. In five patients no clearly identifiable clonal proliferation could be established. Technical limiting factors and the necessity of using multiple cell markers are discussed. These data clearly suggest the usefulness of cell markers for the more precise identification of cellular types, providing more objective bases for prognosis and treatment.