Morphoimmunological characteristics of large-cell anaplastic lymphomas in children.

Combined morphoimmunological studies of tumor elements with a broad panel o f monoclonal antibodies including activation antibody Ki-1(CD-30) enabled u s to single out large-cell anaplastic lymphomas (LCAL) from a group of non- Hodgkin's lymphomas. Morphological features of the tumor elements and their similarity with large-cell sarcomas of different genesis (sarcoma of soft tissues, primitive neuroectodermal tumors, histiocytic tumors, etc.) dictat e the necessity to conduct cytoimmunological differential diagnosis. 23 chi ldren were examined. four types of LCAL were identified: 1. LCAL-Ki1+(CD30), 2.LCAL-Ki1+B-cell (CD30+CD19+CD20+), 3. LCAL-B-cell (CD19+CD20+CD22+), 4 . LCAL-T-cell (CD7+CD4+CD5+). These LCAL types were diagnosed in 8, 5, 6 an d 4 children, respectively. The types 1-3 have similar clinical manifestati ons: severe aggressiveness of the process, rapid dissemination, involvement of different lymph nodes, soft tissues, bones with destruction. Specific a lterations in the bone marrow and CNS were not registered. T-cell phenotype is less aggressive, more frequent involvement of mediastinal lymphatic tis sue and bone marrow. Bones are not involved. There are no definite and pers istent morphological differences in well anaplastic tumor elements in diffe rent LCAL. This makes almost impossible to verify the tumor type. Monoclona l antibodies indicate immunological trend in differentiation of the tumor s ubstrate elements which facilitates choice of adequate treatment schemes th e latter being markedly different from standard schemes of treating other n on-Hodgkin's lymphomas.