Demonstration of light chain monotypia in B cell non-Hodgkin's lymphomas using unfixed freeze-dried and formalin-fixed trypsinised paraffin sections

Patterns of immunoglobulin staining in paraffin-embedded malignant lymphomas

The demonstration of immunoglobulin light chain restriction in paraffin-embedded B cell lymphomas is a capricious and difficult procedure that has been abandoned by many diagnostic laboratories. Using a combination of microwave antigen retrieval performed in a pressure cooker and proteolytic digestion with trypsin, we were able to demonstrate immunoglobulin light chain restriction in 66 B cell lymphomas comprising 25 follicular lymphomas, 29 diffuse large cell lymphomas, 6 small lymphocytic lymphomas, 2 mantle cell lymphomas, 1 nodal marginal zone lymphoma, 1 Burkitt lymphoma, 1 hairy cell leukemia, and 1 plasmacytoma. There was concordance of results in 13 cases in which flow cytometry immunoglobulin analyzes were performed. Perinuclear staining was demonstrated in all cases with dot-like staining of the Golgi present in 23 cases. Perinuclear staining occurred in combination with cytoplasmic staining in 12 cases and membrane staining in 8 cases with 12 lymphomas showing more than two patterns of staining.

High frequency of light chain restriction in labial gland biopsies of Sjögren's syndrome detected by in situ hybridization

A well-recognized complication of Sjögren's syndrome (SS) is the development of malignant lymphoma, with a risk 44 times that of the general population. Although a few clinical signs may indicate the onset of lymphoma, there are few reliable laboratory markers which predict the development of neoplasia. A non-isotopic in situ hybridization technique has been applied to routinely processed labial salivary gland (LSG) biopsies of patients under investigation for SS. Serial section of 70 LSGs were examined for a kappa and gamma immunoglobulin light chain mRNA using digoxigenin-labelled oligonucleotide probes. As controls, 39 biopsies from non-SS-associated sialadenitis were also examined. Sections were analysed using computer-assisted quantification to determine the percentage of kappa-expressing cells in each case. The range of kappa expression in the SS group was 24.1-93.4 percent and in the non-SS group 48.3-75.4 per cent. Light chain restriction was found in 13/70 (18.6 percent) cases from the SS group but in no cases of the control group. Of the SS cases showing restriction, 4/13 (30.7 percent) have subsequently developed extrasalivary gland lymphoma. Two patients not showing light chain restriction in LSG have subsequently developed lymphoma. The positive predictive value of this test to identify patients at risk of lymphoma was 30.7 percent with a detection rate (sensitivity) of 66.7 percent and a false-positive rate of 14.1 per cent(specificity 85.9 percent). This study has identified a high prevalence of light chain restriction in labial gland biopsies of patients with SS and provides objective quantitative criteria to identify those patients at greater risk of lymphoma development.

A comparative study of frozen-section immunoperoxidase and flow cytometry for immunophenotypic analysis of lymph node biopsies

Immunophenotyping by flow cytometry and frozen-section immunoperoxidase was compared on 21 consecutive lymph node biopsy specimens, of which a diagnosis of lymphoma was made for 11 specimens. Samples for flow cytometry were obtained by a fine-needle aspiration technique. Concordance between frozen-section immunoperoxidase and flow cytometry for all routine markers on all specimens ranged from 76 to 100%. In general, B-cell markers showed poorer concordance than T-cell markers, with kappa and lambda light chains having the poorest concordance, at 76% each. Flow cytometry was significantly more sensitive (90 versus 30%; P < 0.006) and had a significantly higher negative predictive value (100 versus 63%; P < 0.006) than frozen-section immunoperoxidase for demonstrating light-chain restriction. There was no significant difference in the specificities (100 versus 91%) or positive predictive values (100% each) between the two methods. Both methods demonstrated characteristic immunophenotypes for intermediate cell lymphomas, small lymphocytic lymphomas, and T-cell lymphoblastic lymphomas. Frozen-section immunoperoxidase and flow cytometry appear to be significantly concordant methods for immunophenotypic analysis of lymph node biopsies. Light-chain restriction is more readily demonstrated by flow cytometry than frozen-section immunoperoxidase. We believe that ex vivo fine-needle aspiration is a simple and reliable method of obtaining cell suspensions of lymph nodes for flow cytometry.

Pathological characteristics of surgically removed craniopharyngiomas: analysis of 131 cases

Pathological specimens of 131 surgically removed craniopharyngiomas were obtained from the registry of the National Institute of Neurosurgery, Budapest between 1977 and 1991. The cases were reviewed statistically with reference to their gross and microscopic features and clinical characteristics. Macroscopically, 34% of the tumours were cystic, 23% solid and 43% mixed. Histologically, 38% of the cases belonged to the adamantinous group, 26% were squamous epithelial type, 15% were combined, that is expressing the characteristics of both. In 21% of the cases the surgically removed samples did not contain enough material for correct histopathologic classification. There was no recurrence in the group with the squamous epithelial type tumours, while 59% of the adamantinous, and 36% of the combined craniopharyngiomas recurred. The 5-year survival proportion was 73% at the squamous epithelial, 60% in the adamantinous, and 55% at the combined histological types.

Cryofixed, freeze-dried and paraffin-embedded skin enables successful immunohistochemical staining of skin basement membrane antigens

Conventional chemical fixation and paraffin-embedding procedures give good preservation of morphology, although the antigenicity of many proteins in the tissue sample is destroyed. On the other hand, fresh frozen sections can preserve the antigenicity, but provide poor morphological preservation. To overcome this dilemma, cryofixation and freeze drying were used on human skin tissue, applying methodology which has only been used to study lymphoid tissue. First, fresh human skin was cryofixed in liquid isopentane (-160 degrees C) cooled by liquid nitrogen. The skin was then freeze-dried at -40 degrees C and 10(-2) atmospheric pressure for 72 h, followed by embedding in paraffin. Sections 4 microns thick taken from this cryofixed, freeze-dried, and paraffin-embedded skin were stained with hematoxylin-eosin or used for immunolabeling with antibodies against basement membrane antigen, including type IV and type VII collagen, bullous pemphigoid antigen, epidermolysis bullosa acquisita antigen, and GB3 antigen. The morphological preservation of these sections was as good as that of routine formalin-fixed and paraffin-embedded skin sections. The basement membrane was clearly immunostained with all antibodies used, and the intensity of the reaction was as strong as that seen in frozen sections. Evaluation of antigen distribution in conjunction with the detailed skin structure was therefore possible in the same sections.

Human ovarian cancers specifically bind daunorubicin-OC-125 conjugate: an immunofluorescence study

This study was designed to test the specific binding to human ovarian serous adenocarcinomas of a drug-antibody conjugate [daunorubicin (DNR-OC-125], made from a new analog (PIPP-DNR) of daunorubicin that chemically links the drug to monoclonal antibodies. We recently reported that the DNR-OC-125 conjugate is selectively toxic in vitro to dividing cell populations of the human ovarian cancer cell lines SK-OV-3 and OVCAR-3 that express the CA-125 antigen [F. Sweet, L. O. Rosik, G. M. Sommers, and J. L. Collins, Gynecol. Oncol. 34, 305-311 (1989)]. In the present study, immunofluorescence data show that the DNR-OC-125 conjugate has high affinity and specificity for proliferating malignant cells from human ovarian tumors. The results demonstrate that the DNR-OC-125 conjugate retains the specific binding to CA-125 antigenic sites characteristic of the OC-125 monoclonal antibody moiety. The DNR-OC-125 conjugate selectively binds to CA-125 antigen-positive ovarian cancerous tissue in both cryostat and paraffin-embedded tissue sections. This is consistent with the earlier in vitro data from dividing populations of two human ovarian cancer cell lines that revealed retention by the DNR-OC-125 conjugate of both the specificity due to OC-125 and the cytotoxicity of daunorubicin. The present immunofluorescence studies in the DNR-OC-125 conjugate is tested on human ovarian serous tumors indicate that the OC-125 monoclonal antibody can indeed serve as a cancer-targeting carrier for daunorubicin and its analogs.

Analysis of leukocyte surface antigens on ethanol-fixed paraffin-embedded tissue material

Ethanol-fixed paraffin-embedded specimens of human tissues were studied whether the surface antigens of leukocytes in these tissues can be stained and analyzed. Three-layer indirect immunoperoxidase staining was performed on the ethanol-fixed paraffin-embedded sections by the use of several monoclonal antibodies for whole human leukocytes (Dako LC), B cells (Dako CD-22, 4KB5, and L26; Leu 14), T cells and their subsets (Dako UCHL-1, T1, T3, T4 and T8; Leu 4, 3a and 2a) and monocyte/macrophage lineage (Dako macrophage, Leu M1, M3 and M5). The results were compared with those on fresh-frozen sections. No essential differences were obtained between the paraffin-embedded and the fresh frozen sections stained by the following antibodies; Dako LC for whole human leukocytes; Dako UCHL-1, T3 and Leu 4 for T cells; Dako CD22, 4KB5, L26 and Leu 14 for B cells; Dako macrophage, Leu M1 and M5 for monocyte/macrophage lineage. On the other hand, the subsets of T cells could only be detected on the fresh-frozen sections. The results of the leukocyte analysis on the paraffin-embedded specimens of several renal diseases were very similar to those reported by other investigators on fresh-frozen sections or PLP-fixed materials. Thus, by the use of appropriate monoclonal antibodies, the ethanol-fixed paraffin-embedded material can be used for leukocyte analysis except for the definition of T cell subsets.

Morphological and immunohistochemical characteristics of dimethylnitrosamine-induced malignant mesenchymal renal tumor in F-344 rats

Mesenchymal renal tumors in F-344 newborn rats were induced by a single dose of dimethylnitrosamine. The induced tumors were successfully transplanted into adult rats under the renal capsule. Neither the primary nor the transplanted neoplasms from various generations of grafts changed their morphological features during the tumor passage, having the same cellularity with high mitotic activity and the tendency to invade the host kidney rapidly. On the basis of lectin histochemistry and immunohistology, the tumor proved to be a mesenchymal neoplasm without any obvious capacity of the proliferating cells to differentiate into any well-known organoid element normally found in mature renal parenchyma. However, the proliferating neoplastic cells were found to have a strong vimentin positivity with desmin expression. Ultrastructurally, myofilaments with attachment bodies characteristic of smooth muscle cells were generally present in various amounts in many tumor cells. In addition, on the basis of the physiological data and on kidney/tumor renin activity obtained, it is interesting to note that the tumor-graft-invaded kidneys retained their enzyme activity, despite the obvious loss of renal tissue including glomeruli. However, the immunohistochemical findings with anti-renin antibody have clearly shown that this is not due to a renin-producing tumor but rather to the surviving (probably) non-neoplastic arterioles retaining the capacity to produce renin. Although these arterioles have mostly been found next to necrotic areas, commonly occurring in dimethylnitrosamine-induced transplantable renal tumors, the question of a possible physiological role of renin in tumor necrosis or in angiogenesis has remained open.

Differential expression of tissue transglutaminase in human cells. An immunohistochemical study

Tissue transglutaminase is an intracellular enzyme without established physiological function. Biochemically it can be detected in all organs, but no systematic in situ localization has been carried out so far. Here we report the immunohistochemical localization of transglutaminase in human tissues using an affinity purified, monospecific anti-human transglutaminase antibody. It is shown that the widespread organ distribution of the enzyme is the consequence of its occurrence in ubiquitous cell types such as endothelium and smooth muscle cells. Some organ-specific cell types express the enzyme constitutively (mesangial cells, renomedullary interstitial cells, thymic subcapsular epithelium, colonic pericryptal fibroblasts), while in others it seems to be induced either by external stimuli (epithelium of the female breast) or as part of their differentiation/maturation program (developing nephrons, enterocytes of the small intestine). The presence of tissue transglutaminase can be demonstrated in derivatives of all germ layers and in the trophoblast. The functional implications of these findings are presently unknown; however, based on its distribution the role of this enzyme in compartmentation and preservation of tissue integrity against stress may be suggested.

Diagnostic significance of histiocyte-related markers in malignant histiocytosis and true histiocytic lymphoma

Interrelationships of immunologic and enzymatic markers of histiocytes have been studied in malignant neoplasms of histiocytic/monocytic origin and in differential diagnostically relevant, large cell non-Hodgkin's lymphomas. Cryostat sections required for demonstrating cell surface antigens by monoclonal antibodies are inadequate for studying cellular detail, enzymatic maturation by alpha-naphthyl acetate esterase (ANAE), and demonstrating the classical cytoplasmic markers of histiocytes like lysozyme, alpha-1-antitrypsin (AT), and alpha-1-antichymotrypsin (ACT). These markers have been compared in gently fixed and vacuum paraffin-embedded material. The reactivity for monoclonal anti-human monocyte 1 (Mo 1) has also been preserved by this method. Malignant histiocytosis (MH) is characterized by a heterogeneous cell population. The mature, ANAE-positive cells with macrophage morphology usually show a diffuse cytoplasmic positivity for AT and ACT. Lysozyme is moderately positive to negative in these cells, but it is more efficient than these markers in revealing smaller cells resembling monocytes by focal positivity in the cytoplasm. The expression of Factor XIIIa (F-XIIIa) is connected with the phagocytic activation of histiocytic cells. F-XIIIa positive cells usually form a minority of the neoplastic population in MH, but the large cytophagocytic marcophages are invariably positive. Reactive macrophages in large cell non-Hodgkin's lymphomas are characterized by a coexpression of ANAE, AT, ACT, lysozyme, F-XIIIa and Mo 1. Typical cases of true histiocytic lymphoma (THL) are made up of a homogeneous population showing the above mature, phagocytizing phenotype. In MH, Mo 1 and ANAE recognize different subpopulations. The reciprocal relation of these markers is an abnormal phenotypic feature. The results presented in this article prove the diagnostic value of ANAE and lysozyme in confirming the histiocytic differentiation of malignant cells. Monoclonal anti-human monocyte 1 is useful for identifying the immature component in MH. Factor XIIIa can be considered a functional marker of mature phagocytic histiocytes and an aid in the diagnosis of THL.

Tumor-associated blood group antigen expressions and immunoglobulins associated with tumors

As outlined in Figures 1 and 2, the biosynthetic pathways for the expression of the A, B and H, and the Lewis determinant carbohydrate sequence structures, as well as sialylated structures, involves both type 1 and type 2 precursor chains (which may be present as glycolipids and N- or O-linked glycoproteins), and many glycosyltransferases. For tumor cells, there appears to be increased expressions of fucosyl- and sialyltransferases yielding such structures as the Le(x), sialyl-Le(a), and many other similar determinants, which are not found on the normal cell progenitor of the tumor. The types of structures expressed on tumor cells is dependent on the particular fucosyl-, sialyl- and other glycosyltransferase genes activated in the transformation and tumor progression events, the availability of the substrates for the glycosyltransferases (both the precursor sequences and the nucleotide-sugar substrates) which is partly dependent on metabolites available to the tumor mass, and on the genotype of the individual regarding particular glycosyltransferases. Both the loss of A, B and/or H blood group antigen expressions of tumor cells and the relative expressions of the Lewis and sialylated-oligosaccharide determinants may be a consequence of the competing biosynthetic pathways and the glycosyltransferases for common substrate sequences, as well as due to the loss of particular glycosyltransferases concomitant with transformation. All of these factors probably account for the variable expressions of the complex of carbohydrate sequence determinants when comparing tumor sections of different individuals as well as the heterogeneity of expression of particular determinants within a single tumor tissue section. As described above, the A, B and/or H determinants, and the precursor sequences, are also expressed to differing extents on epithelial cells depending on the tissue type and cellular location in the tissue. Thus, the differentiation state of the particular epithelial cell also determines the quantity and types of carbohydrate sequences expressed. However, because of the complex nature of the competing biosynthetic pathways for the carbohydrate sequences of glycolipids and glycoproteins, and the relative activations of fucosyl- and sialyltransferases of tumor cells, it would seem that simple deductions as to the state of differentiation of particular tumors with A, B, H and precursor sequence expressions is not warranted.(ABSTRACT TRUNCATED AT 400 WORDS)

Intensification of 3,3'-diaminobenzidine precipitation using the ferric ferricyanide reaction, and its application in the double-immunoperoxidase technique

As in double-immunoperoxidase methods, colour mixing usually indicates unwanted interactions between reagents of the first and second sequences, it is desirable to prevent such superimposition of colours by eliciting adequate colour intensity in the first immunoperoxidase sequence. The brown oxidation product of 3,3'-diaminobenzidine (DAB) in the first immunoperoxidase sequence can be intensified by applying the ferric ferricyanide reaction, resulting in intense greenish-blue staining. When the primary antibody is used at a sufficient concentration, cells labelled in the first sequence do not cross-react with the red chromogen, 3-amino-9-ethylcarbazole (AEC), used in the second sequence. Thus, this double-immunoperoxidase method results in different cell populations being clearly labelled in contrasting colours. Primary antibodies from the same species and the same type of link antibodies can be used in the two separate immunoperoxidase sequences. When primary antibodies raised in different species and two types of link antibodies are used, the method can, without loss of sensitivity, be shortened by performing the first two incubation steps simultaneously.

The AMeX method. A simplified technique of tissue processing and paraffin embedding with improved preservation of antigens for immunostaining

A new simplified tissue processing method for immunostaining was devised. Tissues were fixed in acetone at -20 C overnight, then cleared in methyl benzoate and xylene, consecutively, and embedded in ordinary paraffin at 58-60 C. Thin paraffin sections were deparaffinized with xylene, immersed in acetone and then phosphate buffered saline, and immunostained with various monoclonal and conventional antibodies, which have only been used on fresh-frozen or PLP-fixed frozen sections. As with PLP-fixed frozen sections, the following antigens were clearly demonstrated in the tissue sections processed with the present method: T (Leu-1, Leu-2a, Leu-3a, Leu-4, OKT3, OKT4, OKT8), B (B1, B2, Leu-14, IgM, IgD) lymphocyte surface markers and other antigens (Leu-7, OKT6, OKT9, OKM1, OKI1, J5, Ki-1, Ki-67, TdT, oncogene Ha-ras P21). Sections prepared by the present method demonstrated much better histologic and cytologic preservation than possible in frozen sections.

Identification of histiocytic reticulum cells by the immunohistochemical demonstration of factor XIII (F-XIIIa) in human lymph nodes

Morphologically and enzyme histochemically distinguishable tissue macrophages and stromal cells of human reactive lymph nodes were characterized by the cytoplasmic presence of the subunit A of factor XIII and by the expression of surface antigenic determinants reacting with monoclonal antibodies directed against monocyte/macrophage populations (Mo 1, Leu M3) and HLA-DR antigens. The distribution of F-XIIIa positive cells was studied on formaldehyde-fixed paraffin-embedded sections with immunoperoxidase techniques. established on cryostat section with double immunofluorescence. Alpha-Naphthyl acetate esterase (ANAE) reaction was The immunophenotype was established on cryostat sections with double immunofluorescence. Alpha-Naphthyl acetate esterase (ANAE) reaction was carried out on these cryostat sections to identify tissue macrophages. The antibody against F-XIIIa detected histiocytes in both intra- and extra-sinusoidal locations which were ANAE+, Mo 1+, Leu M3+ and HLA-DR-. F-XIIIa was also present in fibroblast-like mesenchymal cells with the following phenotypic characteristics: ANAE-, Mo 1+, Leu M3+ and HLA-DR+. The anti F-XIIIa antibody did not stain lymphoid cells, granulocytes, epithelial cells, endothelial cells and mast cells. The immunohistochemical detection of F-XIIIa works on formaldehyde-fixed paraffin-embedded sections. The most promising application seems to be the identification of histiocytes in lymphoid and histiocytic proliferations.

Immunoperoxidase study of primary central nervous system lymphomas

Primary central nervous system (CNS) lymphomas have been perceived as CNS counterparts of systemic non-Hodgkin's lymphomas (NHL). Their pathogenesis in respect to the cell of origin, however, has been controversial. A highly sensitive and specific immunoperoxidase method for cytoplasmic immunoglobulins (CIg) using anti-kappa and anti-lambda light-chain antisera in addition to antibodies against IgM, IgG, IgA and IgE heavy chains and J-chain was performed on 27 surgically removed and histologically confirmed primary CNS lymphomas. In order to increase the sensitivity, slides were treated with trypsin to expose the various CIg components. Results indicated that the majority of CNS lymphomas (20 cases or 74.01 percent) were negative for monoclonal CIg. Only four cases (14.81 percent) were definitely positive for CIg with monoclonal staining pattern. Results of the remaining three cases were inconclusive. Among those four cases with positive CIg, three were histologically identified as immunoblastic sarcomas according to the Luke-Collins classification. It is concluded that, in contrast to systemic NHL, primary CNS lymphomas are mostly negative for monoclonal CIg. Whether these CIg negative neoplasms are T and/or null cells in nature or whether they represent an unidentified group of neoplasms is not clear at the present.

Freeze-dried paraffin-embedded human tissue for antigen labelling with monoclonal antibodies

Conventional fixation and paraffin embedding of human tissue destroys most of the antigens detected with currently available antibodies, while cryostat sections give poor morphological detail and require freezer space for storage. However, when tissue was freeze-dried before being embedded in paraffin S then stained for a wide range of antigens recognised by monoclonal antibodies (including T-cell and B-cell antigens), morphological preservation was clearly better, and the labelling reactions were of equal (or greater) intensity, than with cryostat sections. As the number of diagnostically important monoclonal antibodies continues to increase the use of freeze-dried paraffin sections should facilitate the introduction of immunohistological techniques for both routine histopathological diagnostic work and immunological research.